• EmblemHealth (New York, NY)
    …Experience in case management /care coordination, managed care, and/or utilization management (Preferred) Strong communication skills - verbal, written, ... required, with current active RN license (Required) CCM certification (Preferred) Certification in utilization or care management (Preferred) 4 - 6 years of… more
    Upward (07/28/25)
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  • Fenway Health (Boston, MA)
    …objective scientific principles, and the patient's subjective experiences. Conducts virtual, telephonic , or in-person nurse assessment and triage to assess ... Job Type Part-time Description As a Registered Nurse (RN) at Fenway Health you will provide...to the care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care… more
    Upward (07/17/25)
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  • Baystate Health (Springfield, MA)
    RN, ACO Nurse Care Manager, Community Health Center The ACO Nurse Care Manager is responsible for the management of care for a defined group of patients ... face visits, home visits if necessary, as well as telephonic interactions. In addition, they will assist with advance...management application is required and is vital. Care management program metrics including, emergency room utilization ,… more
    Upward (07/19/25)
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  • One Medical (Washington, DC)
    …care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for ... you'll be working on: Treating patients via telehealth visits, including telephonic triage calls, video visit appointments, and email follow-ups Continuous learning… more
    Upward (07/27/25)
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  • US Tech Solutions (Columbia, SC)
    …enrollment in care management programs and/or health and disease management programs. Provides telephonic support for members with chronic conditions, ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
    Upward (07/19/25)
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  • UnitedHealth Group (Minneapolis, MN)
    …oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers Maintain proficiency in all ... together . We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This...of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.… more
    Upward (07/03/25)
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  • Guidehealth (Joliet, IL)
    …settings. Highly experienced in Case Management and Chronic Condition Management . Knowledge of utilization review, quality improvement, managed care, and/or ... on a better path!! Job Description As a registered nurse with an Illinois nursing license, you will work...community health. Previous remote and/or telephonic work experience. Basic knowledge of case … more
    Upward (07/28/25)
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  • Vantage Search Group (Tampa, FL)
    …algorithms, CM software, and databases for community resources. *Integrate CM and utilization management (UM) and integrating nursing case management ... the following; *Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets...and implement local strategies using inpatient, outpatient, onsite and telephonic CM *Develop and implement tools to support case… more
    Upward (07/28/25)
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  • Pair Team (Lodi, CA)
    …and improve outcomes for high-need patients. We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest ... home What You'll Do Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health… more
    Upward (07/23/25)
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  • Elevance Health (Grand Prairie, TX)
    …Job Level: Non- Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... Texas. The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case within the scope of licensure; provides supervision and… more
    Upward (07/24/25)
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  • WMC Health Network (Nyack, NY)
    …and work together with primary care providers and members of the Care Management team. The Ambulatory Care Manger is responsible for coordinating care to obtain ... utilizes evidence-based medicine, data analytics and innovation in implementing care management principles to meet patients and their families' needs. This position… more
    Upward (07/25/25)
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  • Corvel (Folsom, CA)
    …a defined jurisdiction. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides Medical Case Management to individuals through in person and telephonic communications ... CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Folsom, CA. Work from… more
    Upward (07/23/25)
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  • MedStar Health (Baltimore, MD)
    …and social workers. May maintain a post-discharge caseload of assigned patients with timely telephonic case management calls in order to ensure the discharge and ... 9hr shifts with hours varying. Serves as a member of the Case Management Team. Facilitates the delivery of quality, cost effective, patient-centered care from… more
    Upward (07/16/25)
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  • Elevance Health (Topeka, KS)
    …Job Level: Non- Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... for face-to-face member service coordination of all Kansas Medicaid Waivers, not telephonic . Member assessment of benefits is held in the community residential… more
    Upward (07/16/25)
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  • UnitedHealth Group (Metairie, LA)
    …the member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services. We're connecting care to create a seamless health ... referrals to sister segments Educate members on disease processes, self- management and healthy lifestyle changes Complete all organizational and department… more
    Upward (07/20/25)
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  • Telephonic Nurse Case Manager

    ICW Group (Lisle, IL)
    …assessment and evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical ... Current unrestricted Registered Nurse (RN) or Licensed Vocational Nurse (LVN) required. Certification in case management , rehabilitation nursing… more
    ICW Group (06/18/25)
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  • Telephonic Behavior Health Care Manager

    Humana (Hallandale Beach, FL)
    …ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members ... requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families… more
    Humana (07/15/25)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
    LA Care Health Plan (07/08/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbia, SC)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...for supporting the goals and objectives of the Disease Management program by providing high quality telephonic more
    Sharecare (07/12/25)
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  • Workers Compensation Support Registered…

    AdventHealth (Altamonte Springs, FL)
    …A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers Compensation Injury cases. Case ... **The value youll bring to the team:** + Provide telephonic case management for multi-state claim caseload...written consent required, and NC: must be registered rehab nurse with NCIC) + Reports directly to the WC… more
    AdventHealth (07/22/25)
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