- Elevance Health (Pinellas Park, FL)
- …Capabilities and Experiences:** + Bilingual in Spanish strongly preferred. + Previous case management or oncology experience strongly preferred. + Experience ... This is a field based position, candidate would need travel in and around the following counties based on...of an RN, with overall responsibility for the member's case , as required by applicable state law and contract,… more
- Elevance Health (Overland Park, KS)
- …applicable state(s) required. **Preferred Qualifications:** + Experience with Kansas Medicaid Case management or Care coordination Strongly preferred + ... Park KS **Hours:** M - F Standard Working hours ** Travel :** This role enables associates to work virtually full-time,...claims or service issues + Assists with development of utilization /care management policies and procedures, chairs and… more
- Highland Hospital (Rochester, NY)
- …Manager, the RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... **17146BR** **Title:** RN Case Manager PC/FM **Department/Cost Center:** 891 - Highland...experience preferred. Progressive clinical experience including: community health, care management , and/or disease management is preferred. Experience… more
- AdventHealth (Fletcher, NC)
- …32 hours/week. **Shift** : Mon-Friday or 4 days per week. **Location: Travel within Henderson, Polk, Buncombe and Transylvania Counties.** **The role you'll ... on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health patient population requiring the use of advanced… more
- AdventHealth (Fletcher, NC)
- …32 hours/week. **Shift** : Mon-Friday or 4 days per week. **Location: Travel within Henderson, Polk, Buncombe and Transylvania Counties.** **The role you'll ... on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health patient population requiring the use of advanced… more
- Houston Methodist (Sugar Land, TX)
- …on standard. Gathers and enters all documentation in Case Management software and maintains accurate statistics on utilization recommendations. Provides ... clinical nursing/patient care experience which includes three years in utilization review, case management or...etc) regardless of selection below._ + On Call* No ** TRAVEL _** Travel specifications may vary by department**_… more
- Houston Methodist (Houston, TX)
- …with the Physician Advisor to address identified educational needs for providers and utilization review/ case management team members. + Serves as the ... Reads and leads critique of evidence-based practice literature in case management and utilization ...etc) regardless of selection below._ + On Call* Yes ** TRAVEL _** Travel specifications may vary by department**_… more
- Humana (Lansing, MI)
- …care management /coordination within Humana's population health strategy, education, utilization management , and quality improvement activities for the ... Management Director to oversee the processing of LTSS utilization management requests. + Oversee the partnership...education and training programs for LTSS team, inclusive of case review and case study. + Collaborates… more
- Molina Healthcare (Boston, MA)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... dependency services and assists with implementing integrated Behavioral Health care management programs. This position will support our Molina One Care Services… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Essential Accountabilities: Level I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review ... case review determinations. + Provides input into the utilization management program policies and procedures. +...periods of time for business continuity. + Ability to travel across the Health Plan service region for meetings… more