- Molina Healthcare (El Paso, TX)
- …position and productivity is important. Preferred candidates will have previous case management , managed care, inpatient hospital experience._ _TRAVEL in ... _For this position we are seeking a (RN) Registered Nurse who must live in Texas and have a...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- CareFirst (Baltimore, MD)
- …Bachelor's degree in nursing + CCM/ACM or other RN Board Certified certification in case management . Federal Employee Program (FEP) Book of Business (ONLY): Must ... have CCM/ACM or other RN Board Certified certification in case management . Incumbents not certified at the time of hire must have two years of case … more
- Molina Healthcare (Orem, UT)
- …or Licensed Practical Nurse (LPN) Program **REQUIRED EXPERIENCE:** 1-3 years in case management , disease management , managed care or medical or ... 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
- Molina Healthcare (Louisville, KY)
- …Kentucky. Case Manager RN will work with KY Medicaid population providing telephonic case management support. Pediatric and behavioral health experience ... For this position we are seeking a (RN) Registered Nurse who lives in Kentucky and must be licensed...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Rochester Regional Health (Rochester, NY)
- …team and patient through practice, community and home based visits and telephonic support: * Provide comprehensive care management including self- management ... and those at potential risk for adverse healthcare outcomes. The Registered Nurse works in collaboration with primary care providers and the multidisciplinary care… more
- UPMC (Pittsburgh, PA)
- …looking for an opportunity to use your nursing background in outpatient, home health, or case management ? Do you have an interest in health insurance, but thrive ... Medication Review as appropriate. + Refer members to appropriate case management , health management , or...Case Manager (CCM) + Driver's License + Registered Nurse (RN) + Act 33 with renewal + Act… more
- Molina Healthcare (Columbia, SC)
- …psychology, gerontology, public health or social work. **Required Experience** 1-3 years in case management , disease management , managed care or medical or ... applicable state or locality with reliable transportation. **Preferred Experience** 3-5 years in case management , disease management , managed care or medical… more
- Centene Corporation (Lansing, MI)
- …other departments including customer service to resolve member issues. + Refers to case or disease management as appropriate. + Completes special assignments and ... plan compliance to meeting State and Federal standards for HEDIS. Conducts telephonic outreach, while embedded in the providers' offices, to members who are… more
- AmeriHealth Caritas (Shreveport, LA)
- …of case management experience in a hospital, home care, or remote/ telephonic setting + Case management experience within a managed care organization ... Care Manager II (RN) assists members who are appropriate for care coordination and case management services in achieving their optimal level of health.; The Care… more
- Humana (West Palm Beach, FL)
- …in Nursing + 3+ years of managed care experience + 3+ years of case management experience + Strong knowledge of HEDIS/Stars/CMS **Additional Information** + ... Clinical Professional (RN) is responsible for the development, implementation and management oversight of the company's Medicare Stars Program in the SouthEast… more