- Nuvance Health (Danbury, CT)
- …nursing experience required with at least 2 years relevant experience in denials, case or utilization management required. * 5 years management experience ... *Description* *Summary:* The Manager , Denials Prevention & Appeals Operations is responsible...oversight of daily operations of clinical denial prevention and Utilization Review (UR) activities, including daily collaboration with physicians… more
- Superior Court of Fulton County (Atlanta, GA)
- LITIGATION MANAGER **SUPERIOR COURT OF FULTON COUNTY** **JOB ANNOUNCEMENT FOR THE POSITION OF** LITIGATION MANAGER **_SALARY GRADE 20: $68,967_** **Unclassified ... Position** **(Current Vacancy in Case & Court Performance)** **CLOSING DATE: Open Until Filled**...("Court") has an exciting opportunity for an experienced Litigation Manager . Superior Court is Georgia's busiest trial court of… more
- University of Miami (Miami, FL)
- … utilization and prevent loss of reimbursement.UNIVERSITY OF MIAMICore_Sr. Manager , Financial Counseling11. Utilizes financial and decision support systems to ... Cell Administration is currently seeking a full time Sr. Manager , Financial Counseling to work in Miami. The Senior...staff. The incumbent supervises a team of SCT Finance Case Managers while supporting the following areas: Budgeting, Cost… more
- Molina Healthcare (Las Vegas, NV)
- …**Preferred License, Certification, Association** Active, unrestricted Certified Case Manager (CCM) Some experience with Utilization Management processes is ... of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial… more
- UPMC (Pittsburgh, PA)
- …in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required + For Clinical Care Manager + Minimum of ... in medical social work, home care, discharge planning, and case management required. + For Mobile Care Manager... case management required. + For Mobile Care Manager + Pennsylvania Licensure in health or human services… more
- AdventHealth (Winter Park, FL)
- …AdventHealth Orthopedic Institute **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more
- Bon Secours Mercy Health (Emporia, VA)
- …the state in which they are working or covered by compact (required) Accredited Case Manager Certification (ACM) from American Case Management Association or ... Certified Case Manager (CCM) from Commission for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management… more
- Sutter Health (Oakland, CA)
- …acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... **CERTIFICATION & LICENSURE** + RN-Registered Nurse of California Required + Certified Case Manager (CCM) Preferred. **EXPERIENCE** + Minimum of 2 years… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …business case consultant for leadership as they relate to case /disease/ utilization management. * Coordinates the development, revision and implementation of ... Blue Cross and Blue Shield of Minnesota Position Title: Manager - Care Management Location: Hybrid | Eagan, Minnesota...years' experience within insurance or health care setting in case /disease or utilization management * Bachelor's or… more
- Catholic Health (Buffalo, NY)
- …prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease Manager , Population Health, Discharge Planning or ... rotation 8-4pm, 9-5pm Summary: The Registered Nurse (RN) Care Manager -Transition of Care, as an active member of the... Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case management skills critical to working on an interdisciplinary… more