• Registered Nurse

    US Tech Solutions (Columbia, SC)
    …to promote quality, cost effective outcomes. **Responsibilities:** + 60% Provides active case management , assesses service needs, develops and coordinates action ... mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/ case management /clinical/or combination; 2 of the 4 years… more
    US Tech Solutions (06/03/25)
    - Related Jobs

  • Social Worker - Primary Care

    CareOregon (Portland, OR)
    …Worker utilizes palliative care principles, trauma informed care, motivational interviewing and case management strategies. + Participates as a member of ... the largest providers of medical care exclusively in the home in the Western United States. We are proving...be able to maintain healthy boundaries + Ability in case management and counseling with frail and… more
    CareOregon (04/09/25)
    - Related Jobs

  • Remote Member Engagement Specialist

    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
    BeneLynk (06/03/25)
    - Related Jobs

  • Nurse Care Manager PD

    Rush University Medical Center (Chicago, IL)
    …ambulatory or home health setting with a focus in disease or case management . **Responsibilities:** 1. Facilitates communication with patients and care team, ... clinical evaluation of medical and psychosocial needs. Provides timely telephonic outreach to discharged patients in order to better...clinical data to track patient outcomes to determine if case management has improved patient status. 11.… more
    Rush University Medical Center (04/11/25)
    - Related Jobs

  • RN, Field Care Manager, Maternity, L&D, Mother…

    Humana (Columbus, OH)
    …interruptions to protect member PHI / HIPAA information. **Preferred Qualifications** + Case Management Certification (CCM). + Experience working with Medicare, ... through recovery and health and wellness programs. + Performs telephonic and face to face assessments and evaluations of...Medicaid or dual-eligible populations. + Field Case Management Experience. + Health Plan experience.… more
    Humana (05/16/25)
    - Related Jobs

  • Transitional Care Nurse

    Beth Israel Lahey Health (Stoughton, MA)
    …- email, typing, accessing work systems. **Preferred Qualifications:** + Previous nursing case management or medical/surgical experience. VNA Skills. + Nursing ... from an inpatient setting transition safely to the patient's home /community setting. This position will utilize appropriate resources, follow...telephone triage, Chronic Care Management (CCM), discharge planning, skilled telephonic patient… more
    Beth Israel Lahey Health (05/25/25)
    - Related Jobs

  • Pharmacy Technician, Clinical Services (MTM…

    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
    Centene Corporation (06/04/25)
    - Related Jobs

  • Care Manager II

    AmeriHealth Caritas (Philadelphia, PA)
    …+ Minimum of three years of experience as a case manager, preferably providing telephonic case management . + Certification as a case manager ... Overview:** The Care Manager II assists members appropriate for care coordination and case management services in achieving their optimal level of health. The… more
    AmeriHealth Caritas (05/31/25)
    - Related Jobs

  • RN, Field Care Manager - Northern Tidewater…

    Humana (Newport News, VA)
    …without disciplinary action. + Two (2) years of prior experience in health care and/or case management . + One (1) year of experience working with individuals who ... Care Manager (Field Care Manager Nurse 2) to perform telephonic and face-to-face assessments and evaluations of the needs...Bachelor of Science in Nursing (BSN). + Certification in Case Management (CCM). + Previous managed care… more
    Humana (06/05/25)
    - Related Jobs

  • Clinical Operations Manager

    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
    CareOregon (05/22/25)
    - Related Jobs