- ERP International (Nellis AFB, NV)
- …Duties:** * Knowledge of managed care principles, military and civilian population healthcare, case management , utilization management , and demand ... year of hire at contractor's expense. Position may require travel away from normal duty area one to two...last 24 months o Experience in case management , condition management , discharge planning, utilization… more
- ChenMed (Oakland Park, FL)
- …+ Directs referrals to preferred providers. + Coordinates the integration of social services/ case management functions in the pre-acute, ER, acute and post-acute ... Coordinates the patient care, discharge and home planning processes with hospital case management departments, and other healthcare facilities. + In conjunction… more
- Ventura County (Ventura, CA)
- …direction, incumbent is responsible for managing and monitoring the activities of the utilization management , case management , disease management ... - $169,089.57 Annually Location and may be required to travel throughout Ventura County, CA Job Type Full-Time Regular...and monitors the progress of the activities of the utilization management , case management… more
- ChenMed (North Miami, FL)
- …continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent ... e-mail and presentation software. + Ability and willingness to travel locally, regionally and/or nationwide up to 10% of...nursing discipline) required + A minimum of 7 years' utilization review/ case management experience, including… more
- Highmark Health (Harrisburg, PA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Humana (Springfield, IL)
- …managers to ensure alignment and operational efficiency. + Identify members for specific case management and / or disease management activities. + ... health first** Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health… more
- CVS Health (Columbus, OH)
- …in accordance with the benefit plan. + Identifies triggers for referral into Aetna's Case Management , Disease Management , Mixed Services, and other Specialty ... resolution of claims payment issues. Supports the administration of the hospital care, case management and quality management processes in compliance with… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse - ... Care Management Specialist II Job Category: Clinical Department: Care...health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health… more
- Global Foundries (Santa Clara, CA)
- …development programs including market analysis, competitive analysis, investment thesis, business case analysis, and risk management . Collaborate with the ... a highly skilled individual to join the RF Product Management team. In this role, you will join the...value proposition. Create technical content such as white papers, case studies and technical presentations to support marketing efforts.… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Bachelor's Degree Health care related field **Other Qualification Requirements** + Utilization , Case Management , or Quality Management ... Management program that includes initial and concurrent review; case management /discharge planning activities. Responsible for operational planning… more