- Katmai (Usaf Academy, CO)
- **SUMMARY:** Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions. **ESSENTIAL DUTIES & ... on Accreditation of Healthcare Organizations(JCAHO), Ambulatory Health Care (AAAHC) & Case Management Society of America (CMSA)). + Collaborates with military and… more
- Centers for Independence (Milwaukee, WI)
- …(IC) is to assist participants in self-directing services that will meet their long -term care goals and life outcomes. These services are provided through a ... with participants in maintaining financial eligibility by keeping record of when Medicaid reviews are due and by assisting participants in completing forms, making… more
- Commonwealth Care Alliance (Boston, MA)
- …Licensing (must have):** + RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** + 2 to 3 years ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- Somatus (Fairfax, VA)
- …care team, serving both as a patient advocate and a strategic partner to case management teams and hospital staff. This role collaborates with local leadership and ... case management teams at key facilities identified by the Operations Manager to strengthen relationships, improve care coordination, and expand awareness of… more
- Cardinal Health (Carson City, NV)
- …guide successful implementation. Build strong partnerships across Patient Access, Case Management, Specialty Hubs, Pharmacy Operations, IT, and executive leadership. ... appealing and compelling communications (infographics, Veeva Engage posts, slides, manager huddle scripts) tailored to diverse audiences-from frontline teams to… more
- Molina Healthcare (Dayton, OH)
- …License must be active and unrestricted in state of practice. Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... functions: care management, utilization management, behavioral health, care transitions, long -term services and supports (LTSS), and/or other special programs.… more
- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to ... Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or... Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and… more
- CDPHP (Latham, NY)
- …be a part of that experience. The Medicaid Special Programs Registered Nurse Case Manager is responsible and accountable for coordinating the care of CDPHP ... addition, the Medicaid Special Programs Registered Nurse Case Manager is responsible and accountable for...clinical experience is required. + Previous experience working with Medicaid Long Term Care Programs preferred. +… more
- NTT DATA North America (Montgomery, AL)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Medicaid Senior BA to join our team in montgomery, Alabama (US-AL), United ... cycle of assigned projects. The focus will be the Medicaid Claims Processing System. The Senior BA will support...the future CPMS takeover project working with the Project Manager , client and vendor development team to build out… more
- Elevance Health (Durham, NC)
- …may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid . May be responsible for ... **Utilization Management Medical Director- NC Medicaid ** Location: This role enables associates to work...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
