- Highmark Health (Nashville, TN)
- …SUMMARY** This job provides telephonic integrated behavioral and physical health case and condition management services to members with mental health, ... Health with co-morbid medical conditions including pregnancy to provide intensive case management interventions. Provide members with resources and tools… more
- Marriott (Atlanta, GA)
- …a foremost concern in this position. **SCOPE/EXPECTED CONTRIBUTIONS** **Scope** + Provides telephonic case management of associates with occupational ... Case Managers. **Claims Services** + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization review issues. +… more
- CVS Health (Charleston, WV)
- …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
- CVS Health (Baton Rouge, LA)
- …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...payment issues. Supports the administration of the hospital care, case management and quality management … more
- CVS Health (Charleston, WV)
- …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
- LA Care Health Plan (Los Angeles, CA)
- …Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department:...aggregate progress and individual ECM member cases. May use telephonic , onsite, or written methods and both group and… more
- CVS Health (Albany, NY)
- …resolution of claims payment issues. -Supports the administration of the hospital care, case management and quality management processes in compliance with ... for health care service delivery under the direction of nurse or medical director in the most appropriate setting...various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …**POSITION PURPOSE** Responsible for organizing, coordinating, and providing care coordination and case management services to members who are most at risk ... to meet the member's healthcare needs. Through communication, the nurse will identify available resources to promote quality, cost...Professional in Health Care Management , Chronic Disease Management Certification or Case Management … more
- Molina Healthcare (Centralia, WA)
- …assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or ... our Washington State Plan. We are seeking a Registered Nurse with previous knowledge of behavioral health services, substance...triggers from the assessment. + Develops and implements a case management plan in collaboration with the… more
- Cedars-Sinai (Beverly Hills, CA)
- …What You Will be Doing** The Case Manager is responsible for the case management of patient while hospitalized and upon discharge from various care settings. ... are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to...of care preferred + 1 year Previous experience in case management in the acute inpatient or… more