- Highmark Health (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …September 8th, 2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary… more
- Highmark Health (Santa Fe, NM)
- …in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to ... coordinate care , and identifying various resources to assist members in...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
- Baylor Scott & White Health (Santa Fe, NM)
- …experience is required. + You must hold a valid Registered Nurse License ( RN ). As a health care system committed to improving the health of those we ... type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for medical necessity...the healthcare team on resource use to ensure timely care plan follow-through. Your job includes staying in contact… more
- Public Consulting Group (Santa Fe, NM)
- …independently and on a team. + Proven working experience in case management, including as a nurse , medical, mental health care manager or a related job + ... financial, regulatory, and operational challenges of today's changing health care landscape, so they can provide the best ...plans. + Current license, certification or registration as a Registered Nurse or Social Worker **Working Conditions**… more
- Magellan Health Services (Albuquerque, NM)
- … - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt ... and service agency contacts. General Job Information Title Travel Field Care Coordinator - Remote Grade 22 Work Experience - Required Clinical, Quality Work… more
- Genesis Healthcare (NM)
- …a graduate of an approved school of nursing with a license as a Registered Nurse or equivalent professional license (ie Physical Therapist) *Must have Medicare ... the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in...in the communities we serve. Responsibilities This position is remote with some travel to the centers in NM.… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- Sharecare (Santa Fe, NM)
- …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
- Molina Healthcare (Santa Fe, NM)
- …initiating and managing member and/or community interventions (eg, removing barriers to care ) and other federal and state-required quality activities + Monitors and ... within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based… more