• Chief Medical Officer, Health Plan (Based in AZ)

    Molina Healthcare (Chandler, AZ)
    …Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society ... plan in the development and execution of care management and utilization management programs. Develops clinical practice guidelines and oversees appropriateness and… more
    Molina Healthcare (12/24/25)
    - Related Jobs
  • Medical Director- Florida Medicare Plans

    Elevance Health (Tampa, FL)
    …Plans, Freedom Health, and Optimum Healthcare Plans and will be responsible for utilization review case management for these markets. May be responsible for ... State agency. **Preferred Qualifications:** + Bilingual- Spanish speaking preferred. + Utilization Management case review experience strongly preferred. +… more
    Elevance Health (01/09/26)
    - Related Jobs
  • Transplant Care Nurse (Remote)

    Highmark Health (Annapolis, MD)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
    Highmark Health (01/10/26)
    - Related Jobs
  • RN Care Coordinator

    Dignity Health (Long Beach, CA)
    …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
    Dignity Health (01/14/26)
    - Related Jobs
  • RN Care Coordinator

    Dignity Health (Long Beach, CA)
    …or related healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM ... with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability… more
    Dignity Health (01/02/26)
    - Related Jobs
  • Clinical Appeals Nurse (Remote)

    CareFirst (Baltimore, MD)
    …- State Licensure And/or Compact State Licensure Upon Hire Required + CCM - Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified ... in a healthcare payor organization. 2 years' experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, or… more
    CareFirst (01/06/26)
    - Related Jobs
  • Field Clinical Specialist, Las Vegas…

    Edwards Lifesciences (Las Vegas, NV)
    …will make an impact:** + Working independently in the areas of valve crimping, case management, pre- case planning, post- case management, 3 Mensio management, ... educational material during training sessions in order to drive utilization of the Edwards's THV product portfolio. + Utilizing...+ Working independently in the areas of valve crimping, case management, pre- case planning, post- case more
    Edwards Lifesciences (12/17/25)
    - Related Jobs
  • Surgical Core Tech - Thursday- Sunday 10am-8:30pm

    Albany Medical Center (Albany, NY)
    …Functions in the OR setting under the direction of the OR RN clinical manager (s). Assures surgeons' needs as identified on the surgical preference card are complete ... within the surgical cores of supplies and instruments and tracks utilization within the appropriate inventory/instrument control systems as developed and directed… more
    Albany Medical Center (12/10/25)
    - Related Jobs
  • Lead Social Worker MSW

    HCA Healthcare (Ocala, FL)
    …of day as assigned by Manager /Director. + First line resource to Case Managers, Utilization Review, and Medical Social Workers. Elevates issues as ... of caseload for Case Manages based on appropriate level of care, utilization of services and plan of care. Ensures equitable caseload assignments. + Rounds with… more
    HCA Healthcare (12/30/25)
    - Related Jobs
  • RN Care Mgr II

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Care Manager , Continuum of Care Full Time, 80 Hours Per Pay Period , Day Shift M-F. May rotate weekend and minor holidays. Parkwest ... The Continuum of Care Department is staffed by a Manager , Coordinator, RN Care Managers, and Masters Level Social...holidays. Scheduling is centered on team and department needs. Case Managers and Social Workers are available for all… more
    Covenant Health Inc. (01/07/26)
    - Related Jobs