- Healthfirst (NJ)
- 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
- Elevance Health (Walnut Creek, CA)
- …insightful analytics to improve the delivery of care. **Title:** Behavioral Health Care Manager II **Locations:** CA - Cerritos, Walnut Creek, Woodland Hills ... granted as required by law. 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 (Costa Mesa, CA)
- …and insightful analytics to improve the delivery of care. **Behavioral Health Care Manager II - ABA** Location: **Virtual** - This role enables associates ... 8:00 am to 5:00 pm** The **Behavioral Health Care Manager II ** is responsible for managing autism...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Elevance Health (FL)
- **JR169828 Behavioral Health Care Manager II ** Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient ... treatment health benefits through telephonic or written review. The BH Care Manager ( UM ) job progression is primarily a provider-facing role although… more
- HCA Healthcare (Englewood, CO)
- …HealthONE Swedish we support our colleagues in their positions. Join our Team as a(an) Case Management Manager and access programs to assist with every stage of ... and more affordable to gain certifications and job skills. Apply today for our Case Management Manager opening and continue to learn! **Job Summary and… more
- 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
- 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 (Rochester, NY)
- Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program… more
- CDPHP (Latham, NY)
- …values and invites you to be a part of that experience. Conducts case management program activities in accordance with departmental, corporate, NYS Department of ... for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program… more
- Elevance Health (Washington, DC)
- …4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management** **ll** is responsible for managing a team of physical health ... Hires, trains, coaches, counsels, and evaluates performance of both UM + Assists and provides back up coverage to... + Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing… more