- Novo Nordisk Inc. (Plainsboro, NJ)
- …for a living. Are you ready to make a difference? The Position The Manager - Technical Complaints Call Center Oversight is responsible for overseeing the initial ... a positive patient experience and ensure technical complaints are managed with internal timelines, compliance and regulatory requirements. Relationships Reports… more
- Humana (Springfield, IL)
- …discharge planning and patient education for adult acute care . + Managed care experience. + Certified Case Manager (CCM). + Prior experience with ... our caring community and help us put health first** As a Telephonic Nurse Care Manager with Humana Gold Plus-Integrated in Illinois, you will play a pivotal role… more
- CVS Health (Charleston, WV)
- …intervention skills * Managed care /utilization review experience * Certified Case Manager (CCM) certification * Case management experience in an ... with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we...the region, in one of the following counties: The Case Manager RN (CM RN) is responsible… more
- Sharp HealthCare (San Diego, CA)
- …hospital or clinical setting. + 2 Years utilization/ Case Management experience, preferably in a Managed Care setting. + Experience as a case manager ... care for SRS Members. Ensure timely and appropriate processing of managed care referrals to meet specific healthcare criteria in a cost-effective manner… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …possible, and ensure evidence-based treatment is being applied. An experienced case manager with managed care experience will be successful in this ... Care experience or experience as an Oncology Telephonic Case Manager for an insurance company *...US Preferred Skills and Experiences * 2+ years of managed care experience; eg case … 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
- Deloitte (Los Angeles, CA)
- ServiceNow Senior Manager - Consulting Managed Services Enterprise Operations as a Service provides multi-year managed service contracts to support ... is where ambition meets opportunity. As a Deloitte Senior Manager , you will have the opportunity to lead and...experience in either: Consumer, Financial Services, Life Sciences Health Care , Technology Media and Telecom, Energy Resources and… more
- Guthrie (Sayre, PA)
- … Manager monitors clinical approaches and make recommendations for alternate levels of care . The Acute Case Manager also performs Utilization Management ... with the patient and members of the interdisciplinary health care team. The Acute Case Manager...positive and professional relationship with payers that supports continued managed care contracts. c) Articulates the primary… more
- Houston Methodist (The Woodlands, 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
- Henry Ford Health System (Troy, MI)
- …EDUCATION/EXPERIENCE REQUIRED: + Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. + ... GENERAL SUMMARY: Under minimal supervision of the Manager , independently leads financial and data analysis to...to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a… more
- Elevance Health (Winston Salem, NC)
- ** Managed Care Pharmacy Resident** **Location:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, ... new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care . The ** Managed Care Pharmacy Resident** will be… more
- Banner Health (Phoenix, AZ)
- …we want to hear from you. As the RN Case Manager in Care Coordination,...members of the health care team on case management and managed care ... positions require a minimum of one year Case Manager experience in an acute care hospital. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case … more
- Highmark Health (Dover, DE)
- …LTSS. Provides direct oversight to Case Managers, meets all of the requirements of a Case Manager and be able to assist in the day to day responsibilities of ... a Case Manager as needed. This is a...a Case Manager as needed. This is a full time community... management experience + Medicare and Medicaid experience + Managed care experience **SKILLS** + Leadership skills… more
- Banner Health (Tucson, AZ)
- …and resources that promote a healthy work-life balance. As the Registered Nurse RN Case Manager Care Coordination, you will have the opportunity to ... members of the health care team on case management and managed care ...require a minimum of one year Case Manager experience in an acute care hospital.… more
- Banner Health (Mesa, AZ)
- …requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts ... positions require a minimum of one year Case Manager experience in an acute care hospital. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case … more
- CVS Health (Frankfort, KY)
- …it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in ... needs of the member to facilitate and support the member's improved health. The Case Manager develops a proactive course of action to address issues presented… more
- Mount Sinai Health System (New York, NY)
- …as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of 3-5 years experience ... **Job Description** **RN/ Case Manager MSH Case ...and maintains effective working relationships with interdisciplinary team and Case Managers within the managed care… more
- Highmark Health (Dover, DE)
- …+ One year in home clinical or case management experience + Certified Case Manager (CCM) + Licensed Bachelors Social Worker (LBSW) + Licensed Masters Social ... working with developmental disabilities population + Medicare and Medicaid experience + Managed care experience **SKILLS** + Working flexible hours to meet… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …any legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Care Advocacy Case Manager RN - Bilingual Spanish Location: ... and Experience * Fluent bilingual Spanish speaker * 1+ years of managed care experience; eg case management/health coach, utilization management and/or… more
- Charter Care Health Partners (North Providence, RI)
- …required. Center Case Management (CCM) (R) board certification or Accredited Case Manager (ACM (TM) ) is highly desirable. Interrelationships: Patient ... Care Facilities and agencies, Durable Medical Equipment and Ambulance companies, managed care (insurance) personnel and physician office. Working Conditions,… more
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