- Beth Israel Lahey Health (Stoughton, MA)
- …- email, typing, accessing work systems. **Preferred Qualifications:** + Previous nursing case management or medical/surgical experience. VNA Skills. + Nursing ... telephone triage, Chronic Care Management (CCM), discharge planning, skilled telephonic patient interaction and primary care/ambulatory care experience.… more
- Centene Corporation (Tallahassee, FL)
- …execution of DUR initiatives via meeting preparation, letter campaigns, and telephonic outreach to members/providers. + Supports basic data analytic activities and ... audits associated with the over utilization program. + Provides medication therapy management (MTM) services via triage of inbound calls to the MTM hotline,… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of ... patient monitoring practices, medical necessity concepts and associated regulations in case management decisions. Assist in the identification of unnecessary… more
- BeneLynk (San Antonio, TX)
- …REMOTE MEMBER ENGAGEMENT SPECIALIST This position holds accountability for conducting telephonic screening services to Medicare Advantage beneficiaries enrolled in a ... + Meet production/departmental goals by answering inbound calls and conducting telephonic outreach activities to review and assess Medicare Advantage plan member's… more
- Centene Corporation (Harrisburg, PA)
- …other departments including customer service to resolve member issues. + Refers to case or disease management as appropriate. + Completes special assignments and ... to meeting State and Federal standards for HEDIS. Conducts telephonic outreach, while embedded in the providers' offices, to...care gaps identified, and barriers to care. + Conducts telephonic outreach and health coaching to members to support… more
- Point32Health (MA)
- …continuum, including transitions of care, care coordination and navigation, complex case management , population health and wellness interventions, and ... operates + Bachelor's Degree in Nursing preferred + National certification in Case Management desirable **Experience** (minimum years required) **:** + 5+… more
- CareOregon (Portland, OR)
- …+ Keep current on standards for health plan operations related to utilization and case management . + Perform on-going analysis of data and information, looking ... nursing experience, including at least 2 years in utilization management and/or case management Preferred...Facilities/Security ☐ Outdoor Exposure Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person Hazards: May include, but not… more
- US Tech Solutions (Columbia, SC)
- …prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience is preferred. + ... health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/ case management /clinical/or combination; 2 of 4 years must… more
- Molina Healthcare (Cayce, SC)
- …psychology, gerontology, public health or social work. **Required Experience** 1-3 years in case management , disease management , managed care or medical or ... applicable state or locality with reliable transportation. **Preferred Experience** 3-5 years in case management , disease management , managed care or medical… more
- ICF (Orange, CA)
- …and brings extensive, multi-year experience working with ServiceNow as a comprehensive case management system (CMS). **Location** Candidate must live or commute ... involved in immigration proceedings. . Accurately documents call details in a web-based case management or customer relationship management (CRM) system. .… more