- 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 ... + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN state licensure… more
- Sharecare (Augusta, ME)
- … more accessible and affordable for everyone. To learn more, visit www.Sharecare.com. The Care Manager supports the implementation of the Value Based Care ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary… more
- CenterWell (Bangor, ME)
- …sit on-site at our** Bangor, ME **branch location.** The ** RN Clinical Manager ** coordinates and oversees all direct care patient services provided by ... **Branch Location** : Bangor, ME **This is not a remote or work-from-home position. This position requires you to...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Martin's Point Health Care (Portland, ME)
- Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a ... employees are on a mission to transform our health care system while creating a healthier community. Martin's Point..."Great Place to Work" since 2015. Position Summary The Manager , HEDIS Program educates and serves as the HEDIS… more
- Sharecare (Augusta, ME)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... support in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to… more
- Humana (Augusta, ME)
- …Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. **Required Qualifications** + Registered Nurse ( RN ), holding an active and unrestricted ... caring community and help us put health first** The Manager , Fraud and Waste Investigator: Nurse Audit/Review...Condition Categories (HCC) and refers cases for annual follow-up care by disease management, case management, and primary … more
- Healthfirst (ME)
- **This position is 100% Remote **Duties/Responsibilities:** + The Pediatric Care Manager plans and manages pediatric medical and/or behavioral care with ... members and their beneficiaries across the continuum of care . The Care Manager is...services within their coverage plan empowering self-management. + **NYS RN or LCSW, LMSW** + **1 year of pediatric… more
- Sedgwick (Augusta, ME)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign-On Bonus Eligible **We are growing all across the US and are looking ... on the health and lives of others, and a remote work environment that allows face to face interaction...more. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.… more
- CenterWell (Augusta, ME)
- …operations research techniques to model and optimize staffing needs by skill type (eg, RN , PT, HHA), pay type (eg, hourly, salaried), and time type (eg, full-time, ... interruptions to protect member PHI/HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more
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