• After Hours Pediatric Triage RN…

    Atrius Health (Boston, MA)
    …Epic Hyperspace EMR, Avaya phone system, Outlook, QGenda scheduling, and pdf documentation management . . Remote workers must adhere to all Atrius policies ... and delivery market. *SUMMARY * Under the direction of the Clinical Director, Nurse Leader or designee, the professional licensed registered nurse provides… more
    Atrius Health (05/31/25)
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  • Senior LTSS Service Care Manager RN

    Centene Corporation (San Antonio, TX)
    …Licensure required or + NP - Nurse Practitioner - Current State's Nurse Licensure required + For Superior: Resource Utilization Group (RUG) certification ... RN - STAR Plus** **LTSS Comprehensive Care Screening Team** ** REMOTE position but must physically reside within the state...are CST - no exceptions)** **Position Purpose:** Performs care management duties to assess and coordinate all aspects of… more
    Centene Corporation (07/31/25)
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  • Senior Care Manager (RN)

    Centene Corporation (Chicago, IL)
    …- Peoria, IL** **Are you a passionate RN with a strong background in case management or utilization management within an inpatient setting? Join our ... miles of Peoria.** **What We're Looking For:** + **Registered Nurse (RN) with active Illinois license** + **Experience in...(RN) with active Illinois license** + **Experience in case management and/or utilization review** + **Previous work… more
    Centene Corporation (08/03/25)
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  • Uncategorized

    UnityPoint Health (Rock Island, IL)
    …guidelines. + Ensures case coordination with client's health care providers. + Provides utilization management and case management to designated enrollees. ... + Remote : Yes + Area of Interest: Nursing +...make a difference with UnityPoint Health. Responsibilities + Performs utilization and case management reviews using established… more
    UnityPoint Health (06/21/25)
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  • Behavioral Health Clinical Liaison

    Centene Corporation (Frankfort, KY)
    …abuse across the continuum of care. Experience with managed care, case management , utilization management , or quality improvement. **License/Certification:** ... staff, provider and member satisfaction + Serve as resource and liaison on utilization , quality improvement and case management activities + Performs other… more
    Centene Corporation (07/27/25)
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  • Dementia Care Navigator, RN

    Bluestone Physician Services (Wesley Chapel, FL)
    …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage… more
    Bluestone Physician Services (07/24/25)
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  • Telephonic Behavior Health Care Manager

    Humana (Hallandale Beach, FL)
    …and requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or ... employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 11...and engage formerly acquired skillsets to: + Perform care management of pediatric members (under 21) who utilize Applied… more
    Humana (07/15/25)
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  • Case Manager

    Childrens Hospital of The King's Daughters (Norfolk, VA)
    + This position will work weekends only, from 8:00am to 4:30pm. Position will be fully remote but candidate must live in the Virginia area and able to be in Norfolk, ... SUMMARY + The Case Manager is responsible for coordinating the case management care plan to meet the individual/caregiver needs, promoting quality, and… more
    Childrens Hospital of The King's Daughters (06/25/25)
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  • Case Manager, RN (Multiple Openings!)

    Excellus BlueCross BlueShield (Rochester, NY)
    …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
    Excellus BlueCross BlueShield (06/18/25)
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  • Care Manager

    AmeriHealth Caritas (Southfield, MI)
    …the Member's health status, compliance with treatment plans and promote self- management . **Work Arrangement** + Remote **Responsibilities** + Support Members ... complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable + Monitor appropriate utilization and… more
    AmeriHealth Caritas (07/10/25)
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