• Case Manager RN NE - Part Time

    Penn Medicine (Plainsboro, NJ)
    …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. In ... the multi-disciplinary care team to effect timely, appropriate patient management . 1. Addresses/resolves system problems impeding diagnostic or treatment progress.… more
    Penn Medicine (12/24/25)
    - Related Jobs

  • RN Case Manager - St. Louis Children's Hospital

    BJC HealthCare (St. Louis, MO)
    …to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to ... + At least 2 years of RN experience in pediatrics + Prior Case Management experience + BSN **Overview** **St. Louis Children's Hospital** is dedicated to improving… more
    BJC HealthCare (12/24/25)
    - Related Jobs

  • Data Analyst I Healthcare Analytics

    Centene Corporation (Jefferson City, MO)
    …contract/network analysis, and/or ROI evaluation. Familiarity with claims payment, utilization management , provider/vendor contracts, risk adjustment for ... experience in working with large databases, data verification, and data management . Working knowledge of SQL/query languages. Preferred knowledge of programmatic… more
    Centene Corporation (12/24/25)
    - Related Jobs

  • Physician (GP Plus) - LV Craig Family Medicine…

    University of Southern California (Las Vegas, NV)
    …patients with multiple low risk hospitalizations. + 15. Works with contracted utilization management company to discuss patients with complex diagnosis and/or ... refer high risk patients to appropriate specialty services, including assistance in management of home health needs. + 16. Performs other duties as assigned.… more
    University of Southern California (12/23/25)
    - Related Jobs

  • Speech Language Pathologist (SLP) - Inpatient…

    Stanford Health Care (Palo Alto, CA)
    …area. + Knowledge of basic business aspects of position, such as utilization management , charging practices and regulatory practice compliance. + Knowledge ... this requirement for a given quarter, exceptions may be granted based on management 's discretion. **This is a Stanford Health Care job.** **A Brief Overview** The… more
    Stanford Health Care (12/23/25)
    - Related Jobs

  • Senior Physician Executive

    Northern Light Health (Presque Isle, ME)
    …will have an impact on the organization's ability to drive efficiency and utilization management , align both employed and independent medical staff to ... + Excellent verbal and written communication and presentation skills + Effective change management to lead change + High ethical and moral standards Why You'll Want… more
    Northern Light Health (12/23/25)
    - Related Jobs

  • Behavioral Health - Care Manager II

    Elevance Health (Los Angeles, CA)
    …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... complex psychiatric/substance abuse cases required. + Prior managed care experience required. **Preferred Skills, Capabilities, and Experiences:** + BCBA and LBA is STRONGLY PREFERRED For candidates working in person or virtually in the below location(s), the… more
    Elevance Health (12/22/25)
    - Related Jobs

  • Behavioral Health Care Manager I (2nd Shift)-…

    Elevance Health (NC)
    …supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... experience with complex psychiatric/substance abuse cases preferred + ​Bilingual in Spanish is highly preferred _For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and… more
    Elevance Health (12/22/25)
    - Related Jobs

  • Care Coordinator, RN

    Bluestone Physician Services (Detroit Lakes, MN)
    …medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals + Supporting members during ... more years of experience working with the geriatric population in case management /care coordination, Home Care, Nursing Home, TCU or Assisted Living settings… more
    Bluestone Physician Services (12/21/25)
    - Related Jobs

  • RN - Telemetry (Full-Time, 36, Night)

    Queen's Health System (Honolulu, HI)
    …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... and Family Treatment Center includes occasionally accompanying patients outdoors. Management of confused/disoriented and combative patients may involve tasks which… more
    Queen's Health System (12/21/25)
    - Related Jobs