- Sutter Health (Sacramento, CA)
- … care delays/issues as necessary; in collaboration with the Facility Acute Care Manager (CM). This position provides third-party payers clinical information ... SHSO-Sutter Health System Office-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that the right … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created...net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II … more
- Elevance Health (Washington, DC)
- …field preferred. + 3 years management experience with direct reports. + Managed Care Utilization Management experience, preferably in the District. + Working ... week. The office is located at 609 H. Street NE.** The ** Utilization Management** ** Manager ll** is responsible for managing a team of physical health… more
- Elevance Health (Cerritos, CA)
- ** Utilization Management Representative II ** **Location:** Virtual: This role enables associates to work virtually full-time in **CALIFORNIA** , with the ... shift between 8 am - 5 pm PST. The ** Utilization Management Representative II ** is responsible for...to a nurse reviewer; and handles referrals for specialty care . + Processes incoming requests, collection of information needed… more
- Elevance Health (Woburn, MA)
- ** Utilization Management Representative II ** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required ... shift between 8 am - 8 pm EST. The ** Utilization Management Representative II ** is responsible for...to a nurse reviewer; and handles referrals for specialty care . + Processes incoming requests, collection of information needed… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse Case Manager IIDepartment: Home Care Location: West Monroe Hours Per Week: 40Schedule: Days SUMMARY:The RN Case Manager is ... responsible for the delivery of comprehensive nursing care to a set of assigned patients at a...in response to changing patient needs. The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those services… more
- HCR Home Care (Canton, NY)
- … needs in the Health Home Program. This position is designated as a higher-skilled Care Manager , capable of exceeding the basic tenants of care management. ... utilization . + Communicate directly with members of the care team to provide up - to - date...and prioritize multiple assignments. Work Environment The Health Home Care Manager 2 is primarily in an… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The **Member Relationship-Program Manager II -** is a highly visible member of the CAPC team who is responsible for designing and implementing ... to brand loyalty, membership retention and renewal revenue. The Senior Member Relations Manager must identify and address the needs of CAPC members to create… more
- Elevance Health (Rocky Hill, CT)
- **Behavioral Health Care Manager II ** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical ... (two to three times per month).** The **Behavioral Health Care Manager II ** is responsible...outpatient professional treatment health benefits through telephonic or written utilization review. **How you will make an impact:** +… more
- Elevance Health (Columbus, OH)
- **Behavioral Health Care Manager II ** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical ... hours with** **some weekends based upon organizational/business needs.** The **Behavioral Health Care Manager II ** is responsible for managing psychiatric… more
- LA Care Health Plan (Los Angeles, CA)
- Technical Applications Manager II Job Category: Information Technology Department: IT Solutions Delivery Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Technical Application Manager II reports to the Senior ...of HEDIS, HIE, Health Analytics required. Functional knowledge of Utilization Management, Care Management, Clinical Case Management,… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job...such as a health insurance environment and/or experience as care manager in home health or hospice ... support the safety net required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management… more
- AmeriHealth Caritas (Columbia, SC)
- **Role Overview;** The Care Manager II is responsible for managing and coordinating care , services, and social determinants of health for Members with ... care and barriers to care . The Care Manager II develops a...care management platforms where applicable + Monitor appropriate utilization and coordinate services with other payer sources, make… more
- Elevance Health (Atlanta, GA)
- **Behavior Health Care Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law._ The **Behavior Health Care Manager II ** will be...would provide an equivalent background. Previous experience in case management/ utilization management with a broad range of experience with… more
- Elevance Health (Rocky Hill, CT)
- **JR168947 Behavioral Health Care Manager II ** Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and ... health benefits through telephonic or written review. The BH Care Manager (UM) job progression is primarily...of the United States required. + Previous experience in utilization management with a broad range of experience with… more
- Sutter Health (Oakland, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced...+ RN-Registered Nurse of California Required + Certified Case Manager (CCM) Preferred. **EXPERIENCE** + Minimum of 2 years… more
- AmeriHealth Caritas (Detroit, MI)
- **Role Overview:** ;The Care Manager II is responsible for managing and coordinating care , services, and social determinants of health for medically ... timely, complete, and accurate documentation of member interactions in the electronic care management platforms. + Monitor appropriate utilization and coordinate… more
- Parsons Corporation (San Antonio, TX)
- …efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, and business ... We've got what you're looking for. **Job Description:** Parsons is seeking a **Program Manager II ** to support Naval Medical Research Unit - San Antonio… more
- Sutter Health (Modesto, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... are to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced with the patients' self -determination while… more
- Elevance Health (Richmond, VA)
- …employment, unless an accommodation is granted as required by law The **Behavioral Health Care Manager II - Virginia** is responsible for managing ... + Will serve as a resource to other BH Care Managers. + Assists with more complex cases and...requirement for this position. + Previous experience in case management/ utilization management with a broad range of experience with… more