- Managed Care Advisors (Bethesda, MD)
- Position Title:Medical Case Manager EI (Remote) 2024-1366Location:Remote JobJob Category:Medical Case ManagementJob Type:Full TimeDescription:Description ... you looking to make a difference by providing high-quality care with a personal touch that impacts the lives...the occupationally injured? Do you have the professional nursing, case management experience, and licenses necessary to help further… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …certification: 12 months full-time case management experience supervised by a certified case manager , or 24 months full-time case management experience ... not supervised by a certified case manager , or 12 months full-time supervisory experience as a...for access and control throughout NGHS continuum. Facilitates a managed care process that analyzes, orchestrates, and… more
- Pacer Staffing (Atlanta, GA)
- …Technical Skills . Knowledge of TRICARE programs and benefits, managed care concepts, and URAC DM program standards; case management interventions, crisis ... Minimum of three years clinical experience . Experience in case management, care coordination or discharge planning...disease management program settings in a healthcare system or managed care organization (MCO). Preferred . Disease… more
- The University of Vermont Health Network (Camp Johnson, VT)
- …a profound difference in people's lives? Join our Community Hospice team as a Case Manager Registered Nurse and build lasting connections with patients and their ... families. We're dedicated to providing compassionate, expert care that allows individuals to remain comfortably at home...time roles Relocating individuals eligible for $8,200 in a managed budget and $1k cash allowance Links: How UVM… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of improving the health of our communities. About the Role:Job SummaryThe Social Worker Case Manager II is responsible for the provision of medical social work ... as well as disposition needs for each referred patient. Collaborates with RN Case Manager , patients, families, healthcare team members, and community agencies to… more
- Equiliem (Orange, CA)
- Summary:We are seeking a highly motivated and experienced Care Manager , with Behavioral Health experience. The Care Manager is responsible for the ... (BHT) including Applied Behavior Analysis (ABA) services offered to eligible members. The Care Manager will screen, triage and assess members to determine the… more
- Blanchard Valley Health System (Findlay, OH)
- …Current Ohio Licensure as a Registered Nurse Nursing experience 5+ years, 2-4 years in Care Coordination and or Managed Care Knowledge and experience with ... oversight of the interdisciplinary care transition team. The acute care transition manager fosters communication and collaboration across the health… more
- Staffing Now (Carson City, NV)
- …broad range of experience with complex psychiatric/substance abuse cases required. Prior managed care experience required. For URAC accredited areas, the ... expertise to ensure our members are directed to the appropriate level of care . Will be Responsible for managing psychiatric and substance abuse or substance abuse… more
- Accounting Now (Carson City, NV)
- …a broad range of experience with complex psychiatric/substance abuse cases requiredPrior managed care experience requiredFor URAC accredited areas, the following ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
- 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 ... Nurse of California + BLS-Basic Life Support Healthcare Provider + CCM - Certified Case Manager (certification may be required by entity and time to acquire… more
- CVS Health (Columbus, OH)
- …Qualifications:** - Compact RN License or Multi state licensure - Certified Case Manager (CCM) - Managed Care experience - Hospital experience in ICU, ... solutions to make health care more personal, convenient and affordable. This Case Manager RN position is 100% remote and the employee can live in any state.… more
- CVS Health (Olympia, WA)
- …Qualifications** + Behavioral Health experience + Certified Case Manager + Case Management experience + Managed care experience + Strong telephonic ... is Monday - Friday, 8:00am - 4:30pm PST. Nurse Case Manager is responsible for telephonically and/or...by the company) + 3+ years' experience of acute care and/or case management + 2+ years'… more
- Spring Creek Rehabilitation and Nursing Center (Harrisburg, PA)
- …and physical / drug screen. Responsibilites of the Registered Nurse (RN) Case Manager : + Provides communication to the managed care providers regarding a ... Registered Nurse (RN) Case Manager - Monday thru Friday,...care setting. + Proficient in ability to interpret Managed Care /Medicare Advantage Contracts and provide education… more
- Sharp HealthCare (San Diego, CA)
- …care , SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience ... hospital stay beginning with the admission review of the case manager and reviews with the ...and current standards of clinical practice. + Knowledge of managed care and Health Plan contracts. +… more
- AdventHealth (Maitland, FL)
- …Provides guidance and direction to PFS, Central Denials, Patient Access and Managed Care staff regarding contract terms and policies including governmental ... the Florida division. This position assists the Sr. Contract Manager with ensuring that preferred contract language provides for...key contract data elements which are populated into the Managed Care database including addition of new… more
- 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
- Houston Methodist (Houston, TX)
- …planning, utilization management, case management, performance improvement and managed care reimbursement. + Understanding of pre-acute and post-acute ... At Houston Methodist, the Case Manager (CM) Certified position is...communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state,… more
- Molina Healthcare (Bronx, NY)
- … Management program . We are seeking a Registered Nurse with previous Case / Care Management and managed care experience. Candidates with experience in ... of Nursing. Bachelor's Degree in Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or… more
- CommuniCare Health Services Corporate (Akron, OH)
- …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
- ManpowerGroup (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). + ... **Title:** ** Managed Care Coordinator UM II** **Location:...Experience: 7 years-healthcare program management. Preferred Licenses and Certificates: Case Manager Certification, clinical certification in specialty… more
