- Healthfirst (NH)
- …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
- Highmark Health (Concord, NH)
- …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
- Covenant Health (Nashua, NH)
- …and duplication of care and enhancing quality, cost-effective clinical outcomes. The RN Case Manager works closely with, and delegates care to, the High-Risk ... procedures. + Maintains/enhances professional development/skills required to function as a Case Manager and fulfills organizational requirements (ie, data entry,… more
- Dartmouth Health (New London, NH)
- …care and resulting outcomes. * FUNCTIONAL DUTIES AND RESPONSIBILITIES * Clinical Case Management * Determines patient needs and resources within 1-2 business days ... of admission. Initiates discharge planning process. Maintains communication with UM coordinator regarding assessments, outcomes, and projected lengths of stay.… more
- Highmark Health (Concord, NH)
- …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
- Healthfirst (NH)
- …with demonstrated ability to handling rapidly changing crisis situations + Knowledge of UM /QM case philosophies and reporting requirements to state and federal ... agencies + Ability to allocate, monitor, and control resources while delegating and monitoring workloads + Ability to effectively manage performance as well as set and achieve goals **Compliance & Regulatory Responsibilities:** + Ensures Care Management team… more
- Sharecare (Concord, NH)
- …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