- CHRISTUS Health (Los Cerrillos, NM)
- …POSITION SUMMARY: The Clinical Manager is responsible for direction of clinical services in Women 's Services . Works closely with the Director, and ... provider satisfaction. Requirements EDUCATION: Graduate of an accredited program for Registered Nursing. BSN preferred. CERTIFICATION/LICENSES: RN with current… more
- Commonwealth Care Alliance (Springfield, MA)
- …all assessments and ensuring timely submission to MassHealth. The department includes registered nurse assessors and reviewers. The assessors are organized into ... designed to improve outcomes for CCA members. The Assessment nurse reports to the Regional RN Supervisor....to escalate members with urgent needs to the Regional RN Supervisor and/or manager during or immediately… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... responsible for day-to-day timely clinical and service authorization review for medical necessity and... authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of ... no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security** : Must possess… more
- CHRISTUS Health (Santa Cruz, NM)
- Description POSITION SUMMARY: The Registered Nurse is a clinical practitioner who coordinates and implements patient care specific to the age of the patient ... MINIMUM QUALIFICATIONS: EDUCATION: Graduate of an accredited program for Registered Nursing. CERTIFICATION/LICENSES: Current New Mexico RN ...be obtained within 6 months of hire date. If nurse has the required certifications at time of hire,… more
- CHRISTUS Health (Santa Cruz, NM)
- …SUMMARY: The Clinical Manager is responsible for direction of clinical services in Pediatrics. Works closely with the Chief Nursing Executive and the Medical ... Requirements MINIMUM QUALIFICATIONS: EDUCATION: Graduate of an accredited program for Registered Nursing. BSN preferred. CERTIFICATION/LICENSES: RN with current… more
- Commonwealth Care Alliance (Boston, MA)
- 024450 Clin Alli-Care Management **Position Summary:** Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently ... navigate the health care system, gain access to available services , and assist members with finding answers to their...Routine member engagement + Quality gap closures, including: + RN Clinical Care Manager + BH Clinical… more
- Commonwealth Care Alliance (Springfield, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... by providing best-in-class disability competent primary care. Within Care Delivery, the Manager , Clinical Nursing is responsible for the oversight of clinical care… more
- Commonwealth Care Alliance (Boston, MA)
- …(must have): - Meaningful clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment or home care, OR - ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader of the practice. Responsible...role. Supervision Exercised: - Assumes responsibility for all nursing ( RN , LPN) and MA roles in the practice. 10… more
- Commonwealth Care Alliance (Boston, MA)
- …nursing facilities, rehabilitation hospitals, transportation providers, etc.) or long term services and supports (eg Aging Service Access Points, Independent ... CCA-Network Contracting **Position Summary:** Under the direction of the Senior Contract Manager , Provider Contracting, the Senior Provider Contract Manager is… more
- Commonwealth Care Alliance (Boston, MA)
- 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for overseeing relationships and performance with community-based ... Long-Term Services and Supports (LTSS) provider organizations that serve One...with CCA's model of care and strategic objectives. The Manager fosters effective clinical and programmatic collaboration with provider… more
- ERP International (Luke AFB, AZ)
- …work CM services . - Provide patient referrals. - Interface with the MTF RN Case Manager (s) in the development and implementation of the Case Management ... development and implementation of educational programs. - Additionally, the social work case manager may be required to provide those services identified under… more
- Commonwealth Care Alliance (Boston, MA)
- …Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral ... mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary** The Program Manager , in collaboration with the Sr Director of Delegation Partnerships and ... focus on value-based arrangements and network-wide engagement strategies. The program manager is responsible for managing and implementing key population health and… more
- Commonwealth Care Alliance (Boston, MA)
- …and the inpatient hospital admissions that often follow, by offering quality urgent care services in the comfort of the patient's home. Come join this early stage, ... instED operations, from contracting to go-live.. Within this team, the Implementation Manager serves a critical role in driving the implementation of instED's growth… more
- Commonwealth Care Alliance (Boston, MA)
- …CA-Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of ... the implementation of CCA's model of care and strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data… more
- Commonwealth Care Alliance (Boston, MA)
- …medical necessity, appropriateness, and efficiency of the use of health care services , procedures, and facilities under the provisions of CCA's benefits plan. The ... Manager , Utilization Management is responsible for overseeing and managing...managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized clinical… more
- Commonwealth Care Alliance (Boston, MA)
- …the Vice Present, Business Development and Sales instED, the Sales Senior Manager this role is critical to instED's mission to deliver innovative, patient-centered ... care and exceed revenue targets. The Sales Senior Manager will drive strategic growth across new and existing markets, identifying and securing partnerships with… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The Provider Communications Manager is a key contributor responsible for building and nurturing ... with the health plan's model of care and strategic objectives. The Manager will also oversee corporate and business-as-usual (BAU) communications, support regulatory… more
- Commonwealth Care Alliance (Boston, MA)
- …**Required Experience:** Meaningful clinical experience including: + 3+ years' experience as Registered Nurse in a high touch clinical environment or home ... 025010 Clin Alli-CCAPC **Position Summary:** The Primary Care Triage Nurse functions as a key part of the primary...chronic disease management, care coordination, and triage within the RN scope of practice. The Primary Care Triage Nurses… more
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