- Cardinal Health (Santa Fe, NM)
- …+ Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience + ... Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services + Assist in obtaining… more
- Humana (Santa Fe, NM)
- …or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see Language ... community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses...homes. Our nurses are titled Care Managers, because our case management services are centered on the person rather… more
- Humana (Santa Fe, NM)
- …part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage ... EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather...there is limited day to day flexibility in care manager 's schedule. **Duties:** + Telephonically assess Medicare, Medicaid, and/or… more
- CAI (Santa Fe, NM)
- Case Manager , RN **Req number:** R6346 **Employment type:** Full time **Worksite flexibility:** Remote **Who we are** CAI is a global technology services firm ... enterprise. **Job Summary** We are looking for a motivated Case Manager , RN ready to take us...member needs, and develop tailored care plans Preferred: + Case Management Certification (CCM or equivalent) + Bilingual… more
- Molina Healthcare (NM)
- …(provider/plan profiling, member drug profile reviews, medication protocols/criteria, and case -by- case interventions). * Articulates pharmacy management policies ... staff, medical affairs staff, and providers. * Reviews and analyzes Pharmacy Benefit Manager (PBM) reports to track general trends in drug utilization and identify… more
- CVS Health (NM)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- Molina Healthcare (Roswell, NM)
- …behavioral health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... previous case management, discharge planning or care coordination experience Bilingual candidates that speak fluent Spanish are encouraged to apply to support… more
- Health Care Service Corporation (Magdalena, NM)
- …clinical experience. + Patient education experience. + Condition Management experience. + Bilingual in English and Spanish. + Experience in managing complex or ... catastrophic cases. + Certification in Case Management, Training, Project Management or nationally recognized health care certification. + Government Programs… more
- Health Care Service Corporation (Artesia, NM)
- …Fragile Waivers + Patient education experience. + Condition Management experience. + Bilingual in English and Spanish. + Experience in managing complex or ... catastrophic cases. + Certification in Case Management, Training, Project Management or nationally recognized health care certification. + Government Programs… more
- Molina Healthcare (NM)
- …**Community Engagement & Growth Sr Specialist** in/near the **Albuquerque** area **.** ** Bilingual , Spanish speaking is a plus** This role will help drive choice ... activities virtually or in person as needed. **Qualifications:** + Bilingual in Spanish preferred. + Previous experience in sales...model. May also serve as the Acting Supervisor or Manager for the team upon management request. + Responsible… more
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