- Rady Children's Hospital San Diego (San Diego, CA)
- …HMO, Medi-Cal/Medicare and health services. Knowledge of principles and practices of health care service delivery and managed care , Medi-Cal eligibility and ... The PCC will identify and reduce barriers to members' care , assist the member in locating and accessing resources,... system. The PCC may work closely with member's case management team to resolve member concerns, access, medical… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …to provide patients and families with assessment interventions, support, advocacy and case management as a primary provider and/or as ancillary support. Practices as ... diagnosis, family violence, child-protection, and bio-ethical issues - Experience working in an acute- care hospital setting - Registered as an ASW with the Board of… more
- Battelle Memorial Institute (Tampa, FL)
- …to optimize care delivery and outcomes. Additionally, the Nurse Case Manager facilitates referrals, collaborates with healthcare providers, and manages ... sensitive treatment plans which delineate the expected process of care delivery for selected case managed...care goals **Key Qualifications** + Certified as a case manager by a recognized certifying organization,… more
- Somatus (Miami, FL)
- …homes + Telephonic case management experience + Experience working within a managed care environment Other Duties Please note this job description is not ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the...+ BSN or higher level of education + Certified Case Manager (CCM) + Diabetic Educator experience… more
- Stony Brook University (Stony Brook, NY)
- …Training + Experience in Care Management + Experience in Managed Care /Insurance Industry/MD Office. + Certified in Case Management, UR, Quality or Risk + ... Outpatient Care Manager **Position Summary** At Stony...all potential medical interventions. + Demonstrates an understanding of managed care trends, payer regulations and Medicare/… more
- Commonwealth Care Alliance (Boston, MA)
- …management Desired Experience (nice to have): - Experience working with managed care organizations, value-based programs, or community-based behavioral health ... care for members. In this role, the Program Manager acts as an account manager , relationship...across BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …**It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients of ... and utilization management and/or discharge planning experience. Thorough knowledge of managed care , utilization management, discharges planning, and continuous… more
- Commonwealth Care Alliance (Boston, MA)
- …Licensing (must have):** + RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** + 2 to 3 years ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer...Utilization Management experience in a managed care setting + 2 or more… more
- The Toro Company (Bloomington, MN)
- Senior Product Manager , R&D Technology - The Toro Company Who Are We? With roots dating back to 1914, The Toro Company was built on a tradition of quality and caring ... and historic sites around the world. Your Opportunity: The Senior Product Manager , R&D Technology supports the business objectives of the Landscape and Contractor… more
- University Health (San Antonio, TX)
- …a registered nurse is required. National certification in related field is desirable. Case Manager Certification (CCM, CPHQ, or ANCC) or Certified Diabetes Nurse ... managed group to enhance financial outcomes. Will coordinate the transition of care and the interdisciplinary treatment for Medicare managed patients across… more
- Christus Health (Irving, TX)
- …knowledge of discharge planning, case management, performance improvement, and managed care reimbursement. Must understand pre-acute and post-acute levels of ... Leadership: Mentor, train, and support the team of nurse case managers, ensuring high-quality care and adherence...required One of the following certifications is required Certified Case Manager (CCM) by CCMC Nursing … more
- CyrusOne (Chandler, AZ)
- …+ Knows and understands the Owner's building operations rules for the building(s) under his care and as provided by the DC Manager . + Uses and teaches others ... Under the direction of the Senior Facility Manager this role works as a team member...Perform Level 1 response on Windows servers for both non- managed and managed clients, including initial troubleshooting,… more
- Insmed Incorporated (NJ)
- …possible for patients with serious diseases. Reporting to the Compliance Manager , Analytical Services, you'll be essential to maintaining the integrity, accuracy, ... documentation, due to the nature of the documents being managed .Proficiency with Veeva or similar electronic document management systems.Strong...it. You deserve a workplace that reflects the same care you bring to your work each day, with… more
- Katmai (Fort Carson, CO)
- …ensure appropriateness of referrals. + Identify cases that may benefit from alternative levels of care and involve the case manager as needed to provide ... of professional and patient care activities. + Interface with the Managed Care Support Contractor (MCSC) and multidisciplinary personnel as needed to… more
- Katmai (Fort Carson, CO)
- …ensure appropriateness of referrals. + Identify cases that may benefit from alternative levels of care and involve the case manager as needed to provide ... of professional and patient care activities. + Interface with the Managed Care Support Contractor (MCSC) and multidisciplinary personnel as needed to… 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 ... Blue Shield of Minnesota Position Title: RN Specialist Complex Case Manager Location: Remote Career Area: Health...US Preferred Skills and Experience * 2+ years of managed care experience; eg case … more
- Elevance Health (St. Louis, MO)
- …therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the scope ... + Prior "telephonic" Case Management experience with a Managed Care Company preferred + Certification as a Case Manager . + Ability to talk and type… more
- Providence (Mission Hills, CA)
- …Schedules and coordinates all meetings attended by Administrative Director of Managed Care , Contract Manager , Case Managers and UM supervisors. Provides ... Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters… more
- 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 ... and redirect care within the BILH network. **Job Description:** **The Managed Care Coordinator's Responsibilities are:** 1. Work collaboratively with BILH… 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
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