- Healthfirst (NJ)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
- Highmark Health (Trenton, NJ)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Elevance Health (Morristown, NJ)
- …onboarding and skill development. **Shift:** Monday- Friday 8:30-5:00 The Behavioral Health Care Manager ( UM ) job progression is primarily a provider facing role ... to improve the delivery of care. **Title** : Behavioral Health Care Manager - Utilization Management **Location:** **Virtual** : This role enables associates to work… more
- Highmark Health (Trenton, NJ)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Sharecare (Trenton, NJ)
- …hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision ... members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: +… more