- Sedgwick (Cincinnati, OH)
- … staff with larger or more complex claims as necessary. + Makes referral for case management and/or utilization management when work status changes due to ... and changes. + Verifies return to work documentation through telephonic and written communications and records return to work...School diploma or GED required. **Experience** One (1) year case management experience or equivalent combination of… more
- CVS Health (Charleston, WV)
- …BSN preferred + Preferred working with high-risk OB and high risk newborns + Case management in an integrated model preferred + Managed care experience preferred ... The Care Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning,… more
- CVS Health (Burlington, NJ)
- …MS Office Suite applications, including Word and Excel. **Preferred Qualifications** + Certified Case Manager Certification + Case Management experience in ... with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna's Integrated...responsible for assessing and evaluating members with potential care management needs through telephonic and face to… more
- Motion Recruitment Partners (Durham, NC)
- …high cost, or high utilization cases. * May review alternative treatment plans for case management candidates and assess available benefits and the need for ... Case Manager Durham, North Carolina **100% Remote** Contract...+ Non compact licensure **Desired Skills & Experience** + Telephonic experience + shown experience with time management… more
- Boston Health Care for the Homeless Program (Boston, MA)
- …health care, from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations ... Patient Facing: Yes We are seeking an HIV Nurse Case Manager who is interested in a unique opportunity...with primary responsibilities of HIV and other chronic disease management , care coordination, advice/triage needs for the team's patients,… more
- Insight Global (Metairie, LA)
- …Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Prior Case Management Experience . Prior Experience with ... Job Description Insight Global is looking for an Insurance Case Manager to join their client's team in Northern Louisiana . This role involves oversight of medical… more
- CVS Health (Jefferson City, MO)
- …+ Minimum 3+ years of nursing experience + Minimum 2+ years of case management , discharge planning and/or home healthcare coordination experience **Preferred ... care strategies. **Key Responsibilities:** + 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. + Compiles all… more
- AmeriHealth Caritas (Southfield, MI)
- …care, home care, or special needs clinic is required + 3+ years of Case Management experience, preferably telephonic within a managed care organization, ... desired. + Eligible to sit for Case Management certification after 12 months of employment. Must obtain this certification within 24 months of employment. +… more
- CVS Health (Columbus, OH)
- …in accordance with the benefit plan. + Identifies triggers for referral into Aetna's Case Management , Disease Management , Mixed Services, and other Specialty ... resolution of claims payment issues. Supports the administration of the hospital care, case management and quality management processes in compliance with… more
- AmeriHealth Caritas (Columbia, SC)
- …to improve the Member's health status and compliance with treatment plans and promote self- management . The Telephonic Behavioral Health Case Worker is also ... Excel, Outlook), internet applications, and electronic medical record and documentation programs. Electronic Case Management Platform (ie Jiva) + Must be able to… more