• Medical Director - Medicaid Team - FL/SC

    Humana (Topeka, KS)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (10/28/25)
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  • Medical Director - Medicaid N. Central

    Humana (Indianapolis, IN)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (10/25/25)
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  • Care Manager, Registered Nurse

    Sutter Health (Jackson, CA)
    …Hospital **Position Overview:** Coordinates the utilization management , resource management , discharge planning, post - acute care referrals and care ... facilitation. Oversees the management of acute patient populations across the care continuum with a...Joint Commission (TJC). + A broad knowledge base of post - acute levels of care and associated regulatory… more
    Sutter Health (10/17/25)
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  • Nurse Practitioner

    ChenMed (Louisville, KY)
    …role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs. ... role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs.… more
    ChenMed (08/13/25)
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  • Logistics RN Bed Management

    Bassett Healthcare (Cooperstown, NY)
    …service for direct admits and facility transfers + Monitors bed requests for post -procedure admissions (ex. Cath Lab). Assigns bed and status prior to admission. + ... with medical staff regarding patient status, bed placement, payer requirements, and utilization of resources. + Manages Logistic Center staffing process for assigned… more
    Bassett Healthcare (10/29/25)
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  • Social Worker

    ChenMed (Cincinnati, OH)
    …goals. + Supports the integration of social services/case management functions in the pre- acute , ER, acute and post - acute setting. + Coordinates with ... to transition patients to the appropriate level of care post hospital/SNF discharge and may perform post ...activity reports. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: + Assists with the management and plan for transitions of care, discharge and… more
    ChenMed (10/09/25)
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  • Medical Management Coordinator I (Remote)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** This position supports the Post Acute clinical teams and their work coordinating care for CareFirst members by handling ... non-clinical tasks related to preauthorization functions, inpatient care, utilization review, care coordination and/or quality of care, enabling clinical staff to… more
    CareFirst (10/09/25)
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  • Continuing Care Coordinator RN

    Catholic Health Initiatives (Houston, TX)
    …improve performance. + Works closely with and in partnership with Community resource partners, Post Acute Care Providers, Acute Care Coordinators and other ... local market network, this work includes: + Chronic Disease Management -Develops a plan of care based on a nursing...as facilitating seamless transitions of care between clinic and post - acute settings and between clinic and other… more
    Catholic Health Initiatives (10/24/25)
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  • Clinical Appeal and Grievance Nurse

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role BHPS provides Utilization Management (UM) services to its clients, ensuring high-quality, clinically sound decision-making. The Clinical Appeal ... multiple care disciplines including, but not limited to, Inpatient Acute , Post Acute , Outpatient, Specialty...accurate decisions + Ensure strict adherence to Appeals and Utilization Management (UM) processes and regulatory and… more
    Brighton Health Plan Solutions, LLC (10/05/25)
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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Chicago, IL)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence… more
    Select Medical (09/23/25)
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