- Merck & Co. (Grand Rapids, MI)
- …with the in-scope customer team: Customer Team Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. ... pose an undue burden to business operations, in which case you may not be offered employment, or your...by site or organization, with Friday designated as a remote -working day, unless business critical tasks require an on-site… more
- Merck & Co. (Orlando, FL)
- …with the in-scope customer team: Customer Team Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and ... pose an undue burden to business operations, in which case you may not be offered employment, or your...by site or organization, with Friday designated as a remote -working day, unless business critical tasks require an on-site… more
- Alternate Solutions Health Network LLC (Fairfax, VA)
- …/ Company and Hospital guidelines, policies and protocol. Teamwork: Assist with monthly Case Manager, Nurse and Therapy meetings. Participate in all on-call ... Alternate Solutions Health Network LLC is seeking a Registered Nurse (RN) Clinical Liaison for a nursing job in...they are our own FAMILY. Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the… more
- Fallon Health (Quincy, MA)
- **Overview** **The ACO Nurse Case Manager will be working hybrid remote ! This position may require working in an Atrius medical office 1 day/week in either ... or follow us on Facebook, Twitter and LinkedIn. The Accountable Care Organization (ACO) Nurse Case Manager (NCM) is an integral part on an interdisciplinary team… more
- Actalent (Santa Barbara, CA)
- Non-profit healthcare network is looking for a registered nurse case manager to join their team on a contract basis! Opportunity to gain experience with Medi-Cal ... management experience WHAT'S IN IT FOR YOU: + Remote opportunity + Gain experience with a leading healthcare...patient care, and professional nursing standards of practice Skills: Case Management, Medi-Cal, Medicare , RN, health plan… more
- Highmark Health (Harrisburg, PA)
- … Medicare populations. + Bilingual English/Spanish language skills. + Case Management Certification **LICENSES AND CERTIFICATIONS** **Required** + Licensed Social ... with external contacts. + Communicate effectively while interacting with Case Management Specialists, Management Team, Physician Advisors and other interdepartmental… more
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. This is a full-time remote role. The hours for this position are Monday-Friday 8:00a-5:00p CST. Position ... determinant needs. Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and Medicaid. Our Care Managers are frontline advocates for members who… more
- CVS Health (Hartford, CT)
- …and appeal requests. + Develops strategy for review requirements to assure case reviews are overseen by practitioners with relevant clinical expertise. + Applies ... of problem solving and decision making skills Position Summary The Appeals Nurse Consultant position is responsible for processing the medical necessity of … more
- Molina Healthcare (Columbia, SC)
- **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed in the state you reside. We are looking for a Clinical Nurse ... to 4:30PM EST (May have to do weekend coverage in the future) This is a Remote position, home office with internet connectivity of high speed required. (This is a … more
- CVS Health (Montgomery, AL)
- …health care more personal, convenient and affordable. This is a full-time remote role. Hours for this position are Monday-Friday 8:00a-5:00p CST. Requisition Job ... The Care Manager will work in conjunction with the Nurse Care Manager, Care Coordinator, Transition of Care (TOC)...+ CRC, CDMS, CRRN, COHN, or CCM certification + Medicare and Medicaid experience + Managed care experience +… more
- CareFirst (Washington, DC)
- **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that ... incumbent will handle pre and post claim medical review for Commercial and Medicare Advantage Plans. This position assists in determining acceptable medical risk to… more
- Goddard Riverside (New York, NY)
- …to medical care, in-home care, legal services, collaboration with the NORC VNS Nurse , and coordination with NORC case assistance services such as chore ... the functioning of all services within the site and collaborate with NORC Case Assistance staff members, Nurse , Volunteers, Consultants and Program Director *… more
- Texas Health Resources (Arlington, TX)
- **Behavioral Health Case Manager** _We're looking for qualified_ **Behavioral Health Case Managers** _like you to join our Texas Health family._ **Position ... Texas Health Resources: 612 E. Lamar Arlington, TX 76011 ( Remote , must be able to travel to Arlington based...or chemical dependency experience Required and 3 Years in case management or utilization review Preferred **Licenses and Certifications**… more
- Fallon Health (Worcester, MA)
- …to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- ... fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. The UM Nurse uses a multidisciplinary approach to organize, coordinate, monitor, evaluate and modify… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator ( Nurse V) - $7,000 Sign on Incentive! Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4473466) ... Apply Youth Corrections Medical Operations Coordinator ( Nurse V) - $7,000 Sign on Incentive! Salary $105,384.00...includes but is not limited to parole supervision through case management to ensure community safety. We invite you… more
- Molina Healthcare (Bothell, WA)
- …master's degree in Nursing, **Preferred Experience** More than five years Case Management experience. Medicaid/ Medicare Population experience with increasing ... be supporting our Washington State program. We are seeking a Registered Nurse with leadership experience. The Supervisor, Care Management will p** **rovide support… more
- Indian Health Service (Kyle, SD)
- …evening, nights, weekends, and holidays. Collaborates with Unit Supervisors, Chief Nurse Executive, medical staff and the Quality Assurance Performance Improvement ... accrediting organizations standards eg,; The Joint Commission (TJC), Centers of Medicare and Medicaid (CMS), etc. Sets overall objectives and expectations during… more
- AdventHealth (Hinsdale, IL)
- …understanding that **together** we are even better. **Schedule:** Full-time days **Location:** Remote but must be available for in-person meetings every other month ... inpatients, sending/presenting opportunities for improved documentation compliance to physicians, nurse practitioners and other clinical team members. * Transcribes… more
- Providence (OR)
- …a Clinical Program Coordinator RN who will:** + Provide care coordination, case management and care management services to Providence Health Plans(PHP) members + ... educating, motivating and empowering members to manage their disease + ** Case management services include:** triage and referral, transition of care planning,… more
- Trinity Health (Farmington Hills, MI)
- **Employment Type:** Full time **Shift:** **Description:** **POSITION PURPOSE** Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all ... denial and appeal activities with Ministry Organization (MO) based Utilization Review/ Case Management departments; + Reviews and understands utilization review and… more
