- Molina Healthcare (MI)
- …provides care coordination and assistance to member to address concerns. + Collaborates with RN case managers/supervisors as needed or required + Case ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's...to address the member needs and goals. + Conducts telephonic , face-to-face or home visits as required. + Performs… more
- Penn Medicine (East Petersburg, PA)
- …The triage nurse will assist with triage in the EMR inbasket and nurse telephone line, nurse case management, collaboration with clinical teams, ... and related tasks. **Minimum Required Qualifications:** + Current licensure as a Licensed Practical Nurse , or Registered Nurse , issued by the PA State Board… more
- Nuvance Health (Danbury, CT)
- …REQUIRED* * *Hybrid/Remote* * *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within ... the first 12-24 hours and that ongoing communication (electronic and telephonic ) with payers ensures timely approval of all hospital days, preventing delays in… more
- Highmark Health (Albany, NY)
- …Degree if licensed Behavioral Health Professional **Substitutions** + None **Preferred** + If Registered Nurse ( RN ), BSN or MSN preferred **EXPERIENCE** ... provider or providers in more complex clinical situations requiring case management intervention. + Identify on-line, telephonic ...**LICENSES AND CERTIFICATIONS** **Required** Any of the following: + Registered Nurse ( RN ) + Licensed… more
- BlueCross BlueShield of Tennessee (Murfreesboro, TN)
- The Behavioral Health Case Manager for Transitions of Care is dedicated to proactive engagement with members admitted to Acute Inpatient Psychiatric facilities\. ... a hybrid role\. For approximately three days a week, you will work remotely, conducting telephonic outreach to members\. Two days a week, you will visit members in a… more
- George C. Grape Community Hospital (Hamburg, IA)
- Chronic Care Management (CCM) Nurse We are seeking a compassionate and detail-oriented Chronic Care Management (CCM) Nurse to join our team. This role focuses on ... a passion for patient-centered care. Key Responsibilities: * Conduct telephonic outreach and follow-up with patients * Develop and...to care, including social determinants of health. Qualifications: * RN license in Iowa. * Minimum of 2 years… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... to determine medical necessity, appropriate level(s) of care and case management to engage members/enrollees, their families and other...State Licensure. + RN - Registered Nurse in… more
- CareFirst (Baltimore, MD)
- …addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... Care Management Supervisor will direct and coordinate the activities of both telephonic and onsite Clinical Navigators embedded at or assigned to a partnering… more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... State Licensure RN - Registered Nurse in MD, VA or Washington....+ Bachelors degree in nursing. + CCM/ACM or other RN Board certification in case management. +… more
- AmeriHealth Caritas (Detroit, MI)
- …Experience:** + A master's degree in Social Work required or active licensure as a Registered Nurse ( RN ), Licensed Clinical Social Worker (LCSW), or Licensed ... in Microsoft Office Suite (Word, Excel, etc.). **Licensure:** + Active licensure as a Registered Nurse ( RN ), Licensed Clinical Social Worker (LCSW), or… more