- Cardinal Health (Augusta, ME)
- ** Manager , Managed Care ** **What Managed Care contributes to Cardinal Health** Practice Operations Management oversees the business and ... administrative operations of a medical practice. Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal… more
- Highmark Health (Augusta, ME)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... specialization + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/ Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN… more
- Martin's Point Health Care (Portland, ME)
- … care industry, in HEDIS and/or quality improvement. + Experience in managed care health services environment. + Demonstrated knowledge of data collection, ... Join Martin's Point Health Care - an innovative, not-for-profit health care..."Great Place to Work" since 2015. Position Summary The Manager , HEDIS Program educates and serves as the HEDIS… more
- Elevance Health (South Portland, ME)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management...Nurse Case Manager Senior** is responsible for care management within the scope of licensure for members… more
- Elevance Health (South Portland, ME)
- …ICU, Critical Care preferred. + Prior "telephonic" Case Management experience with a Managed Care Company preferred + Certification as a Case Manager . + ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care ...respond to emails/instant messages in a timely fashion. + Managed Care (Home Heath, Insurance, Inpatient) experience.… more
- Elevance Health (South Portland, ME)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with… more
- Humana (Augusta, ME)
- …the (appropriate state) with no disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation as a CCM at hire date, ... holistic approach for case management throughout the continuum of care . The case manager will offer guidance,...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- CDM Smith (Bangor, ME)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
- Takeda Pharmaceuticals (ME)
- …opportunities and adaptability to changing market conditions. + Demonstrated understanding of managed care landscape and how it influences/impacts business. + ... to take charge of your future at Takeda. Join us as a Regional Territory Manager in our New England, North territory. Here, everyone matters, and you will be a… more
- Healthfirst (ME)
- …Qualifications:** + **Masters degree in a related discipline** + **Experience in managed care , case management, identifying alternative care options, ... York State Department of Health (NYSDOH) regulations governing medical management in managed care ** + **Relevant clinical work experience** + **Intermediate… more
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