- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager, Clinical Documentation ... as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and… more
- Sharecare (Albany, NY)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to...+ Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex… more
- CareFirst (Baltimore, MD)
- …preferred. **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... School Diploma or GED **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure RN-...CCM/ACM or other RN Board Certified certification in case management . Incumbents not certified at the time of hire… more
- CareFirst (Baltimore, MD)
- …the field of Medical Surgical, Mental Health, Durable Medical Equipment, and/or Utilization Management , including some experience in research methodology and ... addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure Registered Nurse … more
- Insight Global (Brookfield, WI)
- …cost containment strategies (bill review, utilization review, provider networks, nurse case management ). * Professional designations such as AIC, CPCU, ... the product across claims operations. * Provide expert guidance on medical management , litigation management , and complex claim handling strategies. * Translate… more
- Trinity Health (Columbus, OH)
- …Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation and experience ... the multi-disciplinary team, including physicians, patient care services, case management , coding specialists and other healthcare disciplines regarding clinical… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experience * 2+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience (may be ... Cross and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Management - Transplant Location: Remote Career Area: Health Services About Blue… more
- CVS Health (Charleston, WV)
- …way! The Care Management Associate (CMA) role is a full time remote telework position. Qualified candidates must reside in W. Virginia, any region. This position ... of the state. Through a strong, localized team, an innovative care management model, and creative provider and community advocacy partnerships, Aetna Better Health… more
- Carle Health (Urbana, IL)
- …Hybrid position with 1 day remote and 4 in office The OP Care Management RN provides care management and population health services to patients. The primary ... high vulnerability at times of transition between care settings. OP Care Management RN will coordinate care around patient's chronic diseases, coordinate and… more
- ChenMed (Philadelphia, PA)
- …clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning experience ... on-site at an assigned hospital daily from 9am-3pm, working remote for the remaining hours. The Acute Care Manager,...through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care… more