- CVS Health (Chicago, IL)
- …+ Applies and interprets applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while ... and monitors established plans of care to meet the member's goals. + Utilizes case management and quality management processes in compliance with regulatory… more
- Elevance Health (Goshen, IN)
- …individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any combination of ... capacity, highly preferred. + Experience managing a community and/or facility-based care management case load, highly preferred. Please be advised that Elevance… more
- CVS Health (Indianapolis, IN)
- …is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH ... + This position consists of working intensely as a telephonic case manager with patients and their...overcome barriers to meeting goals and objectives. + Utilizes case management processes in compliance with regulatory… more
- Trinity Health (Athens, GA)
- …Experience and Certification/Licensure** **Licensure/Certification/Registration:** Current GA RN license. Case Management Certification preferred. BLS required. ... 2 years' experience in nursing in a hospital setting; preferred 1 year in case management , utilization management , or discharge planning. **Required Skills… more
- Highmark Health (Dover, DE)
- …programs such as Disease/Chronic Condition Management , Behavioral Health, and Complex Case Management . + Collaborate with the member's health care and ... to complete face to face needs assessments with subsequent telephonic contact with the member in accordance with state...and formulating an appropriate action plan. + Document all case management services and intervention in the… more
- Nuvance Health (Poughkeepsie, NY)
- …supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient ... and economic perspectives. Has overall accountability for the utilization management and transition management for patients within...stay criteria with third party payers (including onsite and telephonic Case Managers) as well as Primary… more
- Ochsner Health (Slidell, LA)
- …patients attributed to the organization and its Network of partner providers. Uses the case management process to assess the healthcare needs of the enrollee, ... experience working in a multi-disciplinary team environment. Preferred - Experience in case management , care coordination or disease management .… more
- CommonSpirit Health (Houston, TX)
- …ICD-9-CM, ICD-10-CM/PCS, MS-DRG, and APR-DRG. + Contacts Case and Utilization Management Teams: Makes telephonic /electronic contacts with case and ... Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case management staff and/or other health… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …utilization of benefits\. + Performing the essential activities of case management : assessment: planning, implementation, coordinating, monitoring, outcomes ... patient education, and reducing readmissions\. This hybrid position involves telephonic outreach and weekly visits to local Acute Inpatient...and evaluation\. + Perform case management activities in community settings including… more
- Elevance Health (Muncie, IN)
- …capacity, highly preferred. + Experience managing a community and/or facility-based care management case load, highly preferred. + MA/MS in Health/Nursing ... ** Case Manager- LCSW/LSW/LMSW/LMHC/LMFT (LTSS Service Coordinator- Clinician)** **Location:**...the scope of licensure including, for example, assisting with telephonic or face-to-face assessments for the identification, evaluation, coordination… more