• UM Case Manager

    Healthfirst (AL)
    …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
    Healthfirst (05/08/25)
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  • Transplant Care Nurse RN - Stem Cell, Bone Marrow…

    Highmark Health (Montgomery, AL)
    …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
    Highmark Health (04/25/25)
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  • Care Manager RN - Remote

    Highmark Health (Montgomery, AL)
    …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
    Highmark Health (05/21/25)
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  • Family Health Advocate - Remote

    Sharecare (Montgomery, AL)
    …hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision ... members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: +… more
    Sharecare (04/12/25)
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