• RN Specialist Complex Case Manager

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …possible, and ensure evidence-based treatment is being applied. An experienced case manager with managed care experience will be successful in this ... Care experience or experience as an Oncology Telephonic Case Manager for an insurance company *...US Preferred Skills and Experiences * 2+ years of managed care experience; eg case more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
    - Related Jobs
  • Telephonic Nurse Case Manager II

    Elevance Health (Grand Prairie, TX)
    …therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the scope ... + Prior "telephonic" Case Management experience with a Managed Care Company preferred + Certification as a Case Manager . + Ability to talk and type… more
    Elevance Health (11/15/25)
    - Related Jobs
  • Managed Care Contract Manager

    AdventHealth (Maitland, FL)
    …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including; governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… more
    AdventHealth (09/12/25)
    - Related Jobs
  • RN Acute Case Manager - System…

    Guthrie (Sayre, PA)
    Manager monitors clinical approaches and make recommendations for alternate levels of care . The Acute Case Manager also performs Utilization Management ... with the patient and members of the interdisciplinary health care team. The Acute Case Manager...positive and professional relationship with payers that supports continued managed care contracts. c) Articulates the primary… more
    Guthrie (10/15/25)
    - Related Jobs
  • Managed Care Contract Reimbursement…

    Henry Ford Health System (Troy, MI)
    …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
    Henry Ford Health System (10/28/25)
    - Related Jobs
  • Case Manager Certified - Transition…

    Houston Methodist (The Woodlands, TX)
    …planning, utilization management, case management, performance improvement and managed care reimbursement. + Understanding of pre-acute and post-acute ... At Houston Methodist, the Case Manager (CM) Certified position is...communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state,… more
    Houston Methodist (10/11/25)
    - Related Jobs
  • Managed Care Pharmacy Resident

    Elevance Health (Mason, OH)
    ** Managed Care Pharmacy Resident** **Location:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care . The ** Managed Care Pharmacy Resident** will be… more
    Elevance Health (11/17/25)
    - Related Jobs
  • RN Case Manager Field Care

    Molina Healthcare (Hampden, MA)
    …of Nursing. Bachelor's Degree in Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or ... **Preferred Education** Bachelor's Degree in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical… more
    Molina Healthcare (10/22/25)
    - Related Jobs
  • RN Registered Nurse Case Manager

    Banner Health (Phoenix, AZ)
    …we want to hear from you. As the RN Case Manager in Care Coordination,...members of the health care team on case management and managed care ... positions require a minimum of one year Case Manager experience in an acute care hospital. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case more
    Banner Health (09/26/25)
    - Related Jobs
  • Supervisor Case Manager Long-term…

    Highmark Health (Dover, DE)
    …LTSS. Provides direct oversight to Case Managers, meets all of the requirements of a Case Manager and be able to assist in the day to day responsibilities of ... a Case Manager as needed. This is a...a Case Manager as needed. This is a full time community... management experience + Medicare and Medicaid experience + Managed care experience **SKILLS** + Leadership skills… more
    Highmark Health (09/22/25)
    - Related Jobs