• Managed Care Case

    Sutter Health (Goleta, CA)
    …AND KNOWLEDGE:** + A broad knowledge base of health care delivery and case management within a managed care environment. + Comprehensive knowledge of ... + RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by...Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care , National Committee for Quality… more
    Sutter Health (07/25/25)
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  • Case Manager Registered Nurse- Field…

    CVS Health (Charleston, WV)
    …intervention skills * Managed care /utilization review experience * Certified Case Manager (CCM) certification * Case management experience in an ... Logan, Mingo, Raleigh, Wyoming, McDowell, Mercer, Summers, Monroe, Greenbrier, Pocahontas.** The Case Manager RN (CM RN) is responsible for telephonically and/or… more
    CVS Health (08/01/25)
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  • Telephonic NICU Nurse Case Manager

    Elevance Health (Latham, NY)
    …multiple states. **Preferred Capabilities, Skills and Experiences:** + Certification as a Case Manager . + Managed Care experience. + Ability to talk and ... **Telephonic NICU Nurse Case Manager II** **Location: Virtual: This... Management. Assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member health care more
    Elevance Health (08/01/25)
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  • Executive Director, Office of Mail Renewal (OMR),…

    City of New York (New York, NY)
    …(MCP), interfaces with managed care delivery systems comprised of Managed Care Organizations (MCOs) and case management providers through which ... Assistance Program (MAP), is recruiting for one (1) Administrative Manager NM-III, to function as the Executive Director, of...the Executive Director, of the Office of Mail Renewal, Managed Care Program (MCP), and Third-Party Health… more
    City of New York (05/14/25)
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  • RN Care Manager - Rex Case

    UNC Health Care (Raleigh, NC)
    …with external care teams + Provide warm handoffs to managed care partners or community navigators **4. Complex Case Rounds (Weekly)** + Facilitate ... support to a network of 6 owned and 10 managed hospitals.** **This position is a 40 hour per...case management, utilization review and discharge planning. The Care Manager must be highly organized professional… more
    UNC Health Care (07/24/25)
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  • Managed Care Claims Validator…

    CommuniCare Health Services Corporate (Charleston, WV)
    …to support our Central Billing Office team. PURPOSE/BELIEF STATEMENT The position of Managed Care Claims Validator / Biller is responsible for accurate and ... timely filing of all managed care claims on their assigned caseload...cash collections team, CBO cash posting team, Business Office Manager , Regional Director of Finance, MDS, Case more
    CommuniCare Health Services Corporate (07/31/25)
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  • Managed Care Contract Reimbursement…

    Henry Ford Health System (Troy, MI)
    …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
    Henry Ford Health System (07/11/25)
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  • RN Acute Case Manager - System…

    Guthrie (Troy, PA)
    Manager monitors clinical approaches and make recommendations for alternate levels of care . The Acute Case Manager also performs Utilization Management ... with the patient and members of the interdisciplinary health care team. The Acute Case Manager...positive and professional relationship with payers that supports continued managed care contracts. c) Articulates the primary… more
    Guthrie (07/29/25)
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  • Acute Care Case Manager

    ChenMed (North Miami Beach, FL)
    Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired. We're ChenMed and we're transforming healthcare for ... facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves... givers, primary care physicians, specialists, other care providers, social workers, other case managers… more
    ChenMed (05/28/25)
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  • Manager Case Management Long-term…

    Highmark Health (Dover, DE)
    …human services field. **EXPERIENCE** + 5 years of a clinical setting + 3 years in a case management/ managed care role + 3 years in a management or leadership ... :** **JOB SUMMARY** This job supervises a team of Case Manager Supervisors who are charged with...professional development skills + Medicare and Medicaid experience + Managed care experience + Experience in geriatric… more
    Highmark Health (06/27/25)
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