• Case Manager - UM II

    Healthfirst (NV)
    The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services and optimal health… more
    Healthfirst (09/12/25)
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  • Manager , Case Management…

    Queen's Health System (Honolulu, HI)
    …manages administrative and clinical operations of Emergency Department and Inpatient Case Management services. * Develops, implements, monitors and evaluates for ... and programs meet all regulatory and accreditation standards and requirements. II . TYPICAL PHYSICAL DEMANDS: * Seeing, hearing, speaking, finger dexterity. *… more
    Queen's Health System (09/09/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …safety net required to achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management ( UM ) Specialist by handling all ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
    LA Care Health Plan (09/09/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Los Angeles, CA)
    **JR162375 Behavioral Health Care Manager II ** Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient ... necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Ability to work with all levels… more
    Elevance Health (09/05/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Wallingford, CT)
    …unless an accommodation is granted as required by law._ The **Behavioral Health Care Manager II ** is responsible for managing psychiatric and substance abuse or ... necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more
    Elevance Health (09/03/25)
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  • Managed Long Term Services and Supports Nurse…

    LA Care Health Plan (Los Angeles, CA)
    …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department: Managed Long Term Services and Supports Location: Los Angeles, CA,… more
    LA Care Health Plan (08/26/25)
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  • Utilization Management Admissions Liaison RN…

    LA Care Health Plan (Los Angeles, CA)
    …- Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case Management Association ... net required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
    LA Care Health Plan (09/10/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Independence, OH)
    **Behavioral Health Care Manager II ** Carelon Behavioral Health **_Virtual_** **_: _** _ _ This role enables associates to work virtually full-time, with the ... improve the delivery of care. The **Behavioral Health Care Manager II ** responsible for managing psychiatric and...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
    Elevance Health (09/06/25)
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  • Medical Services Coordination Specialist I/…

    Excellus BlueCross BlueShield (Rochester, NY)
    …the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims ... and subscriber agreement parameters, and required criteria. + Validates relevant UM /BH/MCM/Quality voice and email inboxes and/or Stored + Information retrieval… more
    Excellus BlueCross BlueShield (08/27/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Indianapolis, IN)
    **Behavioral Health Care Manager II - Indiana** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior ... (EST) to 5:30 pm (EST)** The **Behavioral Health Care Manager II ** is responsible for managing psychiatric...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
    Elevance Health (08/29/25)
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