• Clinical Transition Spec RN

    Carle Health (Urbana, IL)
    …Professional Regulation (IDFPR)Illinois Department of Financial and Professional Regulation (IDFPR); Accredited Case Manager (ACM) within 3 years - American ... utilization issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care… more
    Carle Health (11/19/25)
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  • Clinical Appeals Supervisor (Hybrid)

    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 ... or similar clinical experience OR 5 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, or… more
    CareFirst (10/15/25)
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  • Care Coordinator RN

    Virginia Mason Franciscan Health (Silverdale, WA)
    …+ BLS required within 3 months of hiring if located within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM ... will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute… more
    Virginia Mason Franciscan Health (11/16/25)
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  • Social Worker

    ChenMed (Cleveland, OH)
    …identified by the patient's SDoH Wellness Screening. + Works with patient, family, and case manager to facilitate applications for higher level of care. + Works ... care treatment team including the PCP, other Medical Specialists, LCSW/BHS, and Case Managers. The incumbent in this role is responsible for providing psychosocial… more
    ChenMed (10/09/25)
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  • Human Services Program Supv I - SES

    MyFlorida (Arcadia, FL)
    … Management Performs HIV/AIDS services for patients/clients of the DOH-DeSoto as a Medical Case Manager for Ryan White Part B. Is responsible for client centered ... Lead Agency. This position oversees the DeSoto County Health Departments medical case management services within the HIV/AIDS Program. Job duties include: + Serves… more
    MyFlorida (11/26/25)
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  • Medical Director - Medical Oncology

    Elevance Health (Los Angeles, CA)
    …and providers. **How you will make an impact:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive ... care. + Perform physician-level case review, following initial nurse review, of chemotherapy regimens....and other staff in understanding the principles behind appropriate utilization of covered treatments and genetic testing. + Participate… more
    Elevance Health (11/14/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Owensboro, KY)
    …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
    Molina Healthcare (11/24/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …3 years acute hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience preferred. + Bachelor's ... Job Title: Care Facilitator Department: Case Management Location: Canton-Potsdam Hospital with floating to...in the expected time frame and with most efficient utilization of resources. Carries out activities related to … more
    Rochester Regional Health (10/24/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Lenoir City, TN)
    Overview Registered Nurse Care Manager , Quality Management PRN/OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is ... excellent care to every patient, every time. Position Summary: The RN Care Manager II is responsible for integrating evidenced based clinical practice into the… more
    Covenant Health Inc. (09/04/25)
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  • Director, Comprehensive Care Management

    Baylor Scott & White Health (Dallas, TX)
    …or related field preferred. Master's degree preferred. 2. 5+ years of experience in case management, social work, utilization review, or related field. 3. 1+ ... function of Baylor Scott and White Health (BSWH), which may include case management, social services, coordination of patient care, patient access, utilization more
    Baylor Scott & White Health (11/15/25)
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