• Care Management Associate, Engagement Hub…

    CVS Health (Oklahoma City, OK)
    …we do it all with heart, each and every day. Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member ... is on the Hub's efficiency and productivity efforts whereby the Care Management Associates interact and engage telephonically with members. Through the successful… more
    CVS Health (06/06/25)
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  • Acute Care Nurse, HCT (Registered Nurse)

    ChenMed (Lakeland, FL)
    …+ Direct referrals to preferred providers. + Coordinate the integration of social services/ case management functions in the pre-acute, ER, acute and post-acute ... Coordinate the patient care, discharge, and home planning processes with hospital case management departments, and other healthcare facilities. + In conjunction… more
    ChenMed (04/15/25)
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  • Care Manager - Licensed Behavioral Health…

    Molina Healthcare (Sioux City, IA)
    …for a Licensed Behavioral Health Professional in Iowa to join Molina Healthcare as a telephonic case manager. Applicants should reside in Iowa and hold an LMCH, ... one of the listed licenses and have a strong case management background, you will be given...to address the member needs and goals. * Conducts telephonic , face-to-face or home visits as required. * Performs… more
    Molina Healthcare (04/10/25)
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  • Care Management Supervisor - (Hybrid)

    CareFirst (Baltimore, MD)
    …Licensure and/or Compact State Licensure. **Experience:** 5 years experience in Utilization Management or Case Management at CareFirst BlueCross BlueShield, ... **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates the activities of Inpatient Management Clinical… more
    CareFirst (04/17/25)
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  • Claims Examiner-Lost Time

    TEKsystems (New Haven, CT)
    …are maximized. - Works with in-house Technical Assistants Special Investigators Nurse Consultants Telephonic Case Managers as well as Team Supervisors to exceed ... attorneys to manage hearings and litigation - Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical … more
    TEKsystems (06/04/25)
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  • Master Profile - Registered Nurse / RN

    Always Best Care Senior Services (Hobe Sound, FL)
    …Create a Plan of Service for each client admitted to the Agency. * Provide case management of specifically assigned clients as per Agency policy entitled Case ... all direct client service employees. * Conduct and supervise Case Management Functions. * Always retains the...None Extent of Public Contact: * Considerable personal and telephonic contact with clients, caregivers and client's family members.… more
    Always Best Care Senior Services (05/02/25)
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  • Community Care Nurse, HCT (Registered Nurse)

    ChenMed (Tampa, FL)
    …teamwork skills. Comfortable in giving group presentations + Excellent knowledge of case management principles, healthcare management and reimbursement + ... in their homes but also during center visits and telephonic outreach. The incumbent will implement comprehensive care plans...degree in Nursing (ADN) with 2 years' home health, case management or discharge planning work experience;… more
    ChenMed (05/28/25)
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  • Physician Advisor Denials Management

    CommonSpirit Health (Phoenix, AZ)
    **Responsibilities** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews referred by case management staff and/or other ... effective and efficient utilization of health care services. This individual meets with case management and health care team members to discuss selected cases… more
    CommonSpirit Health (06/06/25)
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  • Care Management Associate

    CVS Health (Frankfort, KY)
    …Length of Stay) to clinical staff. + 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
    CVS Health (05/29/25)
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  • Supervisor, LTSS Clinical Care Management

    Centene Corporation (Newark, DE)
    …once a week to attend leadership meetings.** **Position requires ride-along visits with case managers throughout the whole state of DE.** **Rotating on call** **LTSS ... health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management...ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on… more
    Centene Corporation (06/08/25)
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