• RN Care Manager - Occasional - Days

    Mohawk Valley Health System (Utica, NY)
    …HIPAA. + Performs other related duties as requested by the Executive Director or Clinical Services Manager . + Clarifies issues and actively addresses concerns in ... RN Care Manager - Occasional - Days Department: CARE MANAGEMENT...to determine the correct services and benefits based on medical necessity for an enrollee. Provides plan education, transition… more
    Mohawk Valley Health System (07/09/25)
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  • Manager FT

    Rise Life Services (Middle Island, NY)
    …Residential Habilitation Plans/LRO/SRO for the individuals, works in conjunction with the Case Manager /QIDP to conduct reviews every six months as required- ... Manager FT Job Details Job Location Middle Island...all services for Individuals- including linkages to day treatment, medical , psychiatric, financial, etc. considering the Individuals' choice +… more
    Rise Life Services (09/11/25)
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  • Administrative Medical Assistant

    STG International (Rockville, MD)
    …Responsible for the timely collection of documents required to open and close a Medical Employability Program (MEP) case review in accordance with the MEP AMA ... with all MEP team members and activities. ESSENTIAL FUNCTIONS: Clinical The Joint Commission (TJC) - Quality and Safety...to the MEP Manual AMA process . Review all medical information and submitted case reviews for… more
    STG International (08/28/25)
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  • Registered Nurse Manager Emergency Room

    HCA Healthcare (Cypress, TX)
    …work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA Houston Healthcare North ... passionate about delivering patient-centered care?** Submit your application for Registered Nurse Manager Emergency Room position and spend more time at the bedside… more
    HCA Healthcare (09/04/25)
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  • Manager RN Rehab Inpatient Services

    HCA Healthcare (Conroe, TX)
    …to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA Houston Healthcare Conroe! ... **Are you passionate about delivering patient-centered care?** Submit your application for Manager RN Rehab Inpatient Services position and spend more time at the… more
    HCA Healthcare (07/30/25)
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  • Program Manager For Support Services

    Apicha Community Health Center (Jackson Heights, NY)
    …Position Summary: We're looking for a caring, professional full-time Program Manager for Support Services for our Jackson Heights location. Responsible for ... direct support services programs. The major programs are healthcare case management, grant funded case management, food...+ Recruit and hire program staff assigned. + Provide clinical and administrative supervision to staff by chart review,… more
    Apicha Community Health Center (08/02/25)
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  • Outcomes Manager

    Virtua Health (Mount Holly, NJ)
    …If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than ... and promotes efficient utilization of resources. Acts as a clinical expert and maintains ongoing knowledge of clinical...documentation of individual plan of care in EMR and case management documentation system.* Metrics - Accountable to job… more
    Virtua Health (09/03/25)
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  • Care Manager RN

    Swedish Health Services (Edmonds, WA)
    **Description** Provides clinical case management functions via a collaborative process that transitions patients to optimal clinical outcomes while assuring ... Registered Nurse License upon hire. + 3 years current relevant clinical experience. **Preferred Qualifications:** + Hospital-based case management experience.… more
    Swedish Health Services (08/08/25)
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  • Utilization Management Manager (Hybrid)

    CareFirst (Baltimore, MD)
    …for authorization of services and approved claims. + Prepares retrospective reviews, case appeals, billing coordination, and clinical support. + Manages the ... hiring methods to meet departmental needs. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who is willing and able… more
    CareFirst (07/12/25)
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  • National Accounts Medical Director

    Elevance Health (Metairie, LA)
    …Account clients. The medical director will be responsible for supporting the clinical vision and implementation to deliver an improvement in the health of the ... the health improvement tools offered to clients/ members. The medical director provides clinical expertise in all... expertise in all aspects of utilization review and case management. Provides input on the clinical more
    Elevance Health (08/27/25)
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