• RN Case Manager , Managed

    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 ... + RN-Registered Nurse of California + CCM - Certified Case Manager (certification may be required by...Medicare and Medicaid Services (GR) Grouper (CMS), Department of Managed Health Care , National Committee for Quality… more
    Sutter Health (04/11/25)
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  • RN Case Manager , Managed

    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
    Sutter Health (04/23/25)
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  • Care Manager , Telephonic Nurse 2

    Humana (Tallahassee, FL)
    …patient education for pediatric population + Bilingual English/Spanish + Managed care experience + Certified Case Manager (CCM) **Additional ... a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members'… more
    Humana (04/25/25)
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  • Care Manager RN

    Corewell Health (Grand Rapids, MI)
    …and or case management/ managed care or related field + CRT- Case Manager , Certified About Corewell Health As a team member at Corewell Health, you ... license upon hire + 2 years of relevant experience, clinical nursing and or case management/ managed care or related field Preferred + 5 years of relevant… more
    Corewell Health (04/27/25)
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  • Manager , Managed Care

    Saint Francis Health System (Tulsa, OK)
    …Tulsa, OK Schedule: Monday - Friday | 8:00am - 5:00pm Job Summary: The Manager , Managed Care oversees the modeling, rate development and negotiation ... but not limited to the execution, implementation, and performance of all managed care agreements. Minimum Education: Bachelor's degree in Business Administration… more
    Saint Francis Health System (04/06/25)
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  • Managed Care Account Manager

    Insight Global (Minneapolis, MN)
    Job Description The Managed Care Account Manager will be responsible for developing and managing relationships with managed care organizations. This ... in Worker's Compensation, Auto, General Liability and Disability Management Knowledge of Managed Care Services (Network Utilization, Case Management, Bill… more
    Insight Global (04/26/25)
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  • Program Manager - Managed

    Cedars-Sinai (CA)
    …people throughout Los Angeles and beyond. **Req ID** : 5668 **Working Title** : Program Manager - Managed Care (Hybrid) **Department** : MNS Managed ... **Job Description** The Program Manager is responsible for supporting all facets of...membership. + Monitors and Tracks all other aspects of Managed Care , quality & efficiency measures, Star… more
    Cedars-Sinai (02/05/25)
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  • Executive Director, Office of Mail Renewal (OMR),…

    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
    City of New York (02/12/25)
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  • Managed Care Coordinator

    Beth Israel Lahey Health (Wakefield, MA)
    …taking a job, you're making a difference in people's lives.** The Manager Care Coordinator initiates and process managed care insurance referral requests ... Description:** + **Remote Schedule:** **Monday-Friday from 8:30 am-5 pm** **The Managed Care Coordinator's Responsibilities are:** 1. Work collaboratively with… more
    Beth Israel Lahey Health (04/25/25)
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  • Case Manager - Care

    Beth Israel Lahey Health (Boston, MA)
    …environment. 3. Patient Care Management: + Screens all patients referred to Case Manager for appropriate management and plan development. + Collaborates and ... course to all patients who are referred to the case manager . Identifies case management...Utilizes clinical experiences and expertise in conjunction with the managed care environment in collaborating on clinical… more
    Beth Israel Lahey Health (03/20/25)
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  • Managed Care Claims Validator…

    CommuniCare Health Services Corporate (Charleston, WV)
    …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
    CommuniCare Health Services Corporate (04/28/25)
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  • Managed Care Contract Reimbursement…

    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
    Henry Ford Health System (04/11/25)
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  • Manager , Care Coordination (RN),…

    Stanford Health Care (Palo Alto, CA)
    …social work, care coordination and discharge planning. + Knowledge of managed care and commercial insurance, MediCal, Medicare, and other third-party ... **A Brief Overview** This role independently supervises a multidisciplinary team including case managers, social workers, complex care managers and support… more
    Stanford Health Care (04/16/25)
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  • RN Acute Case Manager - System…

    Guthrie (Binghamton, NY)
    Manager monitors clinical approaches and make recommendations for alternate levels of care . The Acute Case Manager collaborates cooperatively with the ... patient and members of the interdisciplinary health care team. The Acute Case ...positive and professional relationship with payers that supports continued managed care contracts. c) Articulates the primary… more
    Guthrie (02/11/25)
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  • Managed Care Coordinator Clinician…

    Elevance Health (Winston Salem, NC)
    ** Managed Care Coordinator Clinician Non-RN** **Location:** Within 50 miles of a Pulse Point location **Hours:** Monday - Friday, between the hours of 9 am - 6 ... pm CST. The ** Managed Care Coordinator Clinician Non-RN (US)** is...of an RN, with overall responsibility for the members case , as required by applicable state law and contract,… more
    Elevance Health (04/29/25)
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  • Case Manager - Case

    Arnot Health (Elmira, NY)
    …participates in quality improvement and evaluation processes related to the management of patient care . The Case Manager will review all patients for ... Job Description MAIN FUNCTION: The Case Manager coordinates, negotiates, procures services...of care meetings related to the appropriate case managed population. d. Manages the appropriate… more
    Arnot Health (02/06/25)
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  • Case Manager , Ltss (RN) - Personal…

    Molina Healthcare (NY)
    …with disabilities/chronic conditions and Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... **Preferred Education** Bachelor's Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or… more
    Molina Healthcare (04/27/25)
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  • Registered Nurse RN Case Manager

    Banner Health (Tucson, AZ)
    …ready to change lives, we want to hear from you. As the Registered Nurse RN Case Manager Care Coordination, you will have the opportunity to provide ... 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 (04/30/25)
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  • Director of Care Coordination

    Banner Health (Loveland, CO)
    …QUALIFICATIONS Managed care experience preferred; CCM (Certified Case Manager ) preferred. Additional related education and/or experience preferred. ... Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care **Primary Location Salary Range:** $53.63 - $89.38 /...upon your leadership experience daily, including your leadership in Care Coordination and Case Management. Your work… more
    Banner Health (04/19/25)
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  • Registered Nurse Case Manager

    Banner Health (Glendale, 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
    Banner Health (04/13/25)
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