- US Tech Solutions (Columbia, SC)
- …available resources to promote quality, cost effective outcomes. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... strong written clinical skills **.** **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by… more
- US Tech Solutions (Columbia, SC)
- …to elicit behavior change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... Assisting with triage when needed. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by… more
- CVS Health (Kalamazoo, MI)
- …and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. **Position ... to enhance a member's overall wellness. + Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. + Applies clinical… more
- Sutter Health (San Francisco, CA)
- …quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and ... patient experience. The RN Case Manager works in collaboration with the Physician, Medical Social Worker and bedside RN to assure the timely movement of patients… more
- Elevance Health (West Des Moines, IA)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Elevance Health (Indianapolis, IN)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Elevance Health (Mason, OH)
- **Telephonic Nurse Case Manager I** **Sign on Bonus: $3000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of ... different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager I** is responsible for performing care management within… more
- Elevance Health (Charleston, WV)
- **Telephonic RN Nurse Case Manager I** **Sign On Bonus: $3000** **Location: This role enables associates to work virtually full-time, with the exception of required ... in different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager I** is responsible for performing care management within… more
- Elevance Health (Indianapolis, IN)
- ** Nurse Case Manager I - OB** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... an accommodation is granted as required by law._ The ** Nurse Case Manager I - OB** is responsible for...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- CVS Health (Dover, DE)
- …frontline advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management ... Word, Excel, and Outlook - Active and unrestricted Licensed Practical Nurse (LPN) licensure in Delaware. **PREFERRED QUALIFICATIONS** - Ability to multitask,… more