• Dispute Resolution Reviewer I

    St. George Tanaq Corporation (Lansing, MI)
    …Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, healthcare compliance or ... university in healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience in a healthcare… more
    St. George Tanaq Corporation (05/07/25)
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  • Dispute Resolution Reviewer III

    St. George Tanaq Corporation (Phoenix, AZ)
    …+ Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare setting + Must have ... US Eastern, Central or Mountain Time Zones. **Responsibilities** + Reviews medical records/ case file, writes a reconsideration/dispute resolution decision that… more
    St. George Tanaq Corporation (06/25/25)
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  • Inpatient Case Manager BSW, MSW…

    Penn Medicine (Lancaster, PA)
    …of challenges and barriers to discharge including; mental health concerns, high cost medical care, complex medical needs, criminal history, housing ... the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and...Case Manager to join a team of dedicated Case Managers managing a variety complex cases.… more
    Penn Medicine (07/11/25)
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  • Complex Care - Registered Nurse Case

    Henry Ford Health System (Detroit, MI)
    …with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems. + Knowledge of CMS, commercial ... sign on bonus available for qualified experienced candidates with current 2 years RN Case Management in a large acute care hospital setting. GENERAL SUMMARY: The … more
    Henry Ford Health System (05/20/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …access clinical specialty panel physicians to assist in complex or difficult case + Ensure compliance with medical policy. Maintains compliance with all ... Director of Medical Policy and Utilization Review , the Utilization Review Medical ...issues with attending physicians and CCA clinicians + Document case review findings, actions, and outcomes in… more
    Commonwealth Care Alliance (06/27/25)
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  • Manager Case Management - McLaren Careers

    McLaren Health Care (Petoskey, MI)
    …for new supplies and minor equipment purchases. + Fosters smoothly running case management and utilization review services and processes through timely ... attainment of objectives through the selection, development, training, and evaluation of case management and utilization review services staff. + Maintains… more
    McLaren Health Care (05/15/25)
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  • Personal Injury Medical Case Manager

    Price Benowitz LLP (Washington, DC)
    …team. Job Summary Price Benowitz, LLP is looking to add a full-time Personal Injury Medical Case Manager to join its growing team at its Washington, DC ... headquarters. You will coordinate medical case management efforts across our department,...and support to legal team members as needed. + Review and analyze clients' medical records and… more
    Price Benowitz LLP (06/13/25)
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  • Director of Case Management ( RN / RT / MSW…

    Select Medical (Madison, WI)
    …respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience._** **Previous case mangement ( ... discharge planning ) experience with medically complex patients in a hospital critical care setting and...a related discipline. + Minimum three (3) years of medical case management or similar experience. +… more
    Select Medical (07/23/25)
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  • RN Care Manager - Rex Case Management

    UNC Health Care (Raleigh, NC)
    …the unique communities we serve. **Our Case Management team is seeking a System-wide Complex Case Manager to provide support to a network of 6 owned and 10 ... teams + Provide warm handoffs to managed care partners or community navigators **4. Complex Case Rounds (Weekly)** + Facilitate systemwide case rounds for… more
    UNC Health Care (07/24/25)
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  • Director of Case Management ( RN / RT / MSW…

    Select Medical (Newport News, VA)
    …respiratory therapist or master's in social work and minimum three (3) years of medical case management or similar experience._** **Previous case mangement ( ... discharge planning ) experience with medically complex patients in a hospital critical care setting and...a related discipline. + Minimum three (3) years of medical case management or similar experience. +… more
    Select Medical (07/08/25)
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