- Elevance Health (CA)
- ** Medical Management Clinician Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... - Friday 7:00 AM - 3:30 PM PST The ** Medical Management Clinician Senior** is responsible for...+ Develops and fosters ongoing relationships with physicians, healthcare service providers and internal and external customers to help… more
- Elevance Health (Miami, FL)
- ** Medical Management Nurse** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... 7am - 6pm EST and will include weekends. The ** Medical Management Nurse** will be responsible for...member's clinical presentation to determine whether to approve requested service (s) as medically necessary. Works with healthcare providers to… more
- Elevance Health (NC)
- ** Medical Management Clinician Sr** **Location** : **North Carolina.** This role enables associates to work virtually full-time, with the exception of required ... - 5:00 PM EST, with rotating weekend shifts.** The ** Medical Management Clinician Sr** is responsible for...+ Develops and fosters ongoing relationships with physicians, healthcare service providers and internal and external customers to help… more
- Elevance Health (NC)
- ** Medical Management Specialist I** **Location** : **North Carolina.** This role enables associates to work virtually full-time, with the exception of required ... - 5:00 PM EST, with rotating weekend shifts.** The ** Medical Management Specialist I** is responsible for...Microsoft Office Suite and Microsoft Excel. + Excellent customer service skills preferred. _For URAC accredited areas, the following… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- … requests. + Reviews cases referred by the prior-authorization non-clinical medical management coordinator and pre-certification technician staff according to ... Position Is Not Remote Position Purposes: Evaluates and approves requested services using organizational policies or MCG(R) screening criteria. Responsibilities: +… more
- Elevance Health (St. Louis, MO)
- ** Medical Management Clinician Associate** **Location:** **Virtual -** This role enables associates to work virtually full-time, with the exception of required ... 8:00 am to 4:30 pm Eastern Standard Time** The ** Medical Management Clinician Associate** is responsible for...policies. **How you will make an impact:** + Confirms medical services are appropriate based on assigned… more
- Elevance Health (Mason, OH)
- …health, long term services and supports, and psychosocial needs._ ** Medical Management Specialist I** **Location:** This role requires associates to ... holidays, may be required based on operational needs. The ** Medical Management Specialist I** is responsible for...follow up on activities of care coordination. + Confirm service initiation and coordinate service delivery +… more
- Bellefaire JCB (Cleveland, OH)
- … management , the Medical Case Manager administers the full scope of Medical Case Management Services utilizing the highest standards of practice, ... Engage parents/caregivers and youth in case management services , home health care services , medical...and standards. + Maintain and update progress notes documenting services provided, duration of service , progress toward… more
- AmeriHealth Caritas (Philadelphia, PA)
- …the performance standards embodied in the HEDIS program. + Assuring a high-performing Medical Management system that adheres to the terms of contracts and ... order to develop interventions to improve clinical effectiveness of medical management strategies. + Works closely with...Assists IHCM Managers in assessing members' need for case management services + Attends case management… more
- WellSpan Health (York, PA)
- WellSpan Medical Weight Management is seeking a dynamic Internal Medicine or Family Medicine physician who is board certified in Obesity Medicine. A good ... 20-minute follow-up. + May eventually develop a Pediatric Weight Management Program. **WellSpan Medical Group Offers:** +...Provide a broad range of diagnostic and therapeutic health services + Perform physical exams and health histories +… more