- CareFirst (Baltimore, MD)
- …home or other levels of care. Utilizing experience and skills in both care management and utilization management , the Onsite Clinical Navigator will leverage ... Required. **Experience:** 5 years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review.… more
- Dignity Health (Rancho Cordova, CA)
- …responsible for providing telephonic clinical assessment, health education and utilization management services to a variety of patients. **Job Requirements** ... triage nurse experience + Familiarity with an electronic practice management system **Where You'll Work** Dignity Health Medical Foundation, established in 1993,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experience * 1+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience. * ... across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets and… more
- Trinity Health (Berwyn, IL)
- …for an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general supervision, manages ... pre-certification requests for eligible members received via portal, EHR, or telephonic , for outpatient and inpatient elective services specified on the… more
- CareFirst (Baltimore, MD)
- …Washington. **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... **PURPOSE:** This position will support the Maryland government programs care management team, specifically the Medicare Advantage line of business. The Care… more
- Commonwealth Care Alliance (Springfield, MA)
- …care management . + Crisis and substance use experience, including telephonic . **Desired Experience (nice to have):** + Experience with electronic medical record ... Intensive Care (CIC) programing is responsible for providing care delivery and care management to a specific panel of high risk and complex people. This panel… more
- WellSense (Manchester, NH)
- …circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members throughout the continuum of care by assessing ... the member's overall experience with the health care delivery system. Utilizing both telephonic outreach and face to face member visits and through the use of… more
- Point32Health (MA)
- …with the interdisciplinary care team, to improve member outcomes (ie, Utilization Management , Medical Director, pharmacy, community health workers, dementia ... management , population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses… more
- Albany Medical Center (Albany, NY)
- …of America) Salary Range: $83,200.00 - $128,960.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse (RN) - Full TimeHIV Medicine Clinic - Albany, NY We have an ... comprehensive HIV services including primary medical care, medical case management , medication adherence, peer services, substance abuse counseling, mental health… more
- Baylor Scott & White Health (Mckinney, TX)
- …Associate's degree in nursing. Specialty Certification strongly encouraged. Knowledge of care management , resource and utilization management . Skilled in ... outcomes by effectively managing care and resources to reduce unnecessary utilization . **Location: McKinney, TX** **Setting: Case Management ** **Schedule: Full… more
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