- 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 ... for health care service delivery under the direction of nurse or medical director in the most appropriate setting...payment issues. Supports the administration of the hospital care, case management and quality management … more
- 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
- 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...care costs. We are looking for an experienced Registered Nurse and people leader with UM/CM experience living within… more
- TEKsystems (New Haven, CT)
- …with attorneys to manage hearings and litigation - Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers ... recovery opportunities are maximized. - Works with in-house Technical Assistants Special Investigators Nurse Consultants Telephonic Case Managers as well as… more
- UPMC (Williamsport, PA)
- …orthopedic patient population. The navigator will provide high quality nursing care, telephonic case management , and care coordination throughout the ... UPMC is looking for a highly motivated Orthopedic Nurse Navigator/Coordinator to work as part of a...4 years nursing experience in a hospital setting. + Telephonic case management experience highly… more
- 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 ... for health care service delivery under the direction of nurse or medical director in the most appropriate setting...issues. + Supports the administration of the hospital care, case management and quality management … more
- 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
- Molina Healthcare (MS)
- …assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or ... triggers from the assessment. * Develops and implements a case management plan in collaboration with the...to address the member needs and goals. * Conducts telephonic , face-to-face or home visits as required. * Performs… more
- Molina Healthcare (San Francisco, CA)
- …assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or ... triggers from the assessment. + Develops and implements a case management plan in collaboration with the...to address the member needs and goals. + Conducts telephonic , face-to-face or home visits as required. + Performs… more
- Molina Healthcare (TX)
- …for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and diligence are especially ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...to address the member needs and goals. + Conducts telephonic , face-to-face or home visits as required. + Performs… more