• Supervisor , Care Management

    Centene Corporation (Tallahassee, FL)
    …that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management ... related to members or providers. + Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and… more
    Centene Corporation (09/24/25)
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  • Supervisor , LTSS Clinical…

    Centene Corporation (Dover, DE)
    …health needs and/or behavioral/mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care ... related to members or providers. + Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and… more
    Centene Corporation (10/05/25)
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  • Supervisor Medicare LTSS Operations

    AmeriHealth Caritas (Detroit, MI)
    …for ensuring and improving the performance, productivity and efficiency of Medicare LTSS Care Coordination Operations. Under the supervision of the Manager ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...services. + Ensures effective daily operation of the Medicare LTSS Care Coordination team complying with all… more
    AmeriHealth Caritas (10/04/25)
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  • Provider Relations Representative - ( LTSS

    Molina Healthcare (Dayton, OH)
    …such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care , and correct coding. * Independently ... in-office work is required. + Preferred experience with MyCare Ohio and LTSS . **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible… more
    Molina Healthcare (08/27/25)
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  • Supervisor Service Coordinator

    AmeriHealth Caritas (Scranton, PA)
    … and services.; + Maintains operational processes, policies, and procedures to support LTSS care delivery + Ensure quality and performance metrics are ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...Participants.; + Serves as a subject matter expert for LTSS training for internal care teams and… more
    AmeriHealth Caritas (09/06/25)
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  • Service Coordinator, Supervisor - Dauphin…

    UPMC (Camp Hill, PA)
    …working from home and in office. Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports ( LTSS ) program serving seniors and ... UPMC Health Plan is looking for Service Coordinator Supervisor positions to join the Community HealthChoices team...information. + Responsible for the operational functions of the LTSS Team primarily focused on the service coordination model… more
    UPMC (07/18/25)
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  • Supervisor , Case Management (Long…

    Centene Corporation (Topeka, KS)
    …that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management ... candidate will have a Bachelor's degree and previous case management experience, preferably working with the LTSS ...to members or providers. + Monitors and reviews long-term care management required documentation to maintain and… more
    Centene Corporation (09/24/25)
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  • RN UM Supervisor , Healthcare Services must…

    Molina Healthcare (GA)
    care management , utilization management , behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs. ... MUST reside in Georgia **Essential Job Duties** + Assists in implementing health management , care management , utilization management , behavioral health… more
    Molina Healthcare (09/26/25)
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  • Nurse Supervisor , Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    care management , utilization management , behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs. ... member care . **Essential Job Duties** * Assists in implementing health management , care management , utilization management , behavioral health… more
    Molina Healthcare (09/25/25)
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  • Supervisor Case Manager Long-term…

    Highmark Health (Dover, DE)
    …and to promote effective use of resources for members enrolled in DSHP Plus LTSS . Provides direct oversight to Case Managers, meets all of the requirements of a ... the day to day activities as needed. + Ensure care is medically appropriate, high quality, and cost effective....population + Two years in home clinical or case management experience + Medicare and Medicaid experience + Managed… more
    Highmark Health (09/22/25)
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  • Medicare Long Term Services & Support Care

    AmeriHealth Caritas (Detroit, MI)
    …at www.amerihealthcaritas.com. **Role Overview: ;** Reporting to the Supervisor of Medicare LTSS Operations, the Medicare LTSS Care Coordinator manages ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...LTSS ), and psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid… more
    AmeriHealth Caritas (09/19/25)
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  • Registered Nurse (RN) Utilization…

    Commonwealth Care Alliance (Boston, MA)
    …CCM (Certified Case Manager) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years ... Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...Care experience + 2 or more years of LTSS experience + 2 or more years working in… more
    Commonwealth Care Alliance (10/02/25)
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  • Care Manager

    BrightSpring Health Services (Fayetteville, NC)
    …documentation of billable events that align with minimum contact expectations to the Care Management Supervisor . + Maintains an accurate, up-to-date ... concern, general departmental activities and staffing needs to the Care Management Supervisor . + Completes...years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management more
    BrightSpring Health Services (09/18/25)
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  • Manager I Care Management

    Elevance Health (NC)
    …services, long term services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina where all children ... accommodation is granted as required by law._ **The Manager Care Management , Foster Care ** (Manager...very strongly preferred. + At least 2 years of management / supervisor experience (with direct reports) is needed… more
    Elevance Health (10/03/25)
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  • Case Manager Registered Nurse/License Practical…

    CVS Health (Bassett, VA)
    …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Case Manager Registered Nurse position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of the Martinsville and… more
    CVS Health (08/23/25)
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  • Coord Appeals & Grievances

    AmeriHealth Caritas (Newark, DE)
    care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care , stay well, and build healthy communities. As one of the nation's leaders… more
    AmeriHealth Caritas (09/03/25)
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  • Associate Manager Clinical Health Services - Must…

    CVS Health (IL)
    …each and every day. The Supervisor is responsible for oversight of LTSS /Waiver healthcare case management staff including the organization and development of ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (10/03/25)
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