- Public Consulting Group (Raleigh, NC)
- …www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible ... publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers… more
- Guardian Life (Raleigh, NC)
- The **Group Life/Supplemental Health Claims Case Manager II** is responsible for making timely and accurate decisions on assigned claims through proactive ... superior customer service to all internal and external customers. The Claims Case Manager II administers claims within a variety of group sizes ranging from… more
- CenterWell (Youngsville, NC)
- …of our caring community and help us put health first** As a **Home Health RN Case Manager ** , you will: + Provide admission, case management, and follow-up ... for home health patients. + Administer on-going care and case management for each patient, provide necessary follow-up as...patient, provide necessary follow-up as directed by the Clinical Manager . + Confer with physician in developing the initial… more
- CenterWell (Youngsville, NC)
- …and help patients get back to the life they love. As a **Home Health RN Case Manager ** , you will: + Provide admission, case management, and follow-up ... for home health patients. + Administer on-going care and case management for each patient, provide necessary follow-up as...patient, provide necessary follow-up as directed by the Clinical Manager . + Confer with physician in developing the initial… more
- CVS Health (Raleigh, NC)
- …flexibility required to accommodate members needs. Bilingual in English/Spanish Nurse Case Manager is responsible for telephonically assessing, planning, ... implementing and coordinating all case management activities with members to evaluate the medical...Reviews prior claims to address potential impact on current case management and eligibility. - Assessments include the member's… more
- Guardian Life (Raleigh, NC)
- …and acts as the critical communication link, in conjunction with the assigned Disability Case Manager where applicable, for all parties in FML client absence ... the best at what they do. The FML Leave manager is responsible for proactively managing Leave of Absence...with key partners including Clients, Claimants, Nurse and Disability Case Managers, Risk Management. . Administer claims within a… more
- Gentiva (Raleigh, NC)
- …the care they need with dignity, grace, and love. **As a Hospice RN/ RN Case Manager , you will:** + Reportdirectly to the Administrator, Executive Director or ... and performance improvement programs. **About You** **Hospice Registered Nurse / RN Case Manager Requirements:** + Hospice heart: compassionate, kind and… more
- CVS Health (Raleigh, NC)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- Cardinal Health (Raleigh, NC)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... effective solutions. + Provide guidance and training to junior case managers on best practices in case ...junior case managers on best practices in case management, patient interaction, and navigating internal and external… more
- Guardian Life (Raleigh, NC)
- …with Group Disability claims experience to join our dynamic Appeals Team. The Appeals Case Manager II (ACM 2) is responsible for adjudicating assigned appeals ... insights and learnings with claims colleagues. **Reporting Relationships:** As our Appeals Case Manager II, you will report to our Leader, Appeals Team, who… more
- Allied Universal (Raleigh, NC)
- …and exclusive perks. Allied Universal(R) is hiring a Special Investigations Unit (SIU) Investigator/ Case Manager ! _ Work from home anywhere in the United States ... to effectively obtain required information for completion of state fraud referrals; case findings; & audits. + Communicates compliance requirements to clients and… more
- Cardinal Health (Raleigh, NC)
- …supervisor or senior peers on complex and unusual problems **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement ... Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the healthcare providers through the various process steps in support of their patient's journey to therapy. These steps include… more
- Cardinal Health (Raleigh, NC)
- …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Case Manager supports patient access to therapy through Reimbursement ... Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake,… more
- Highmark Health (Raleigh, NC)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- Cardinal Health (Raleigh, NC)
- …+ Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience + ... Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services + Assist in obtaining… more
- Public Consulting Group (Raleigh, NC)
- …teams responsible for implementing and supporting our services and solutions. The Program Manager is a key advisor and thought partner to clients, playing a ... as needed, but is mostly remote. The portfolio of projects for this Program Manager are within the northeast United States and requires the successful candidate to… more
- Evolent (Raleigh, NC)
- …Pacific Coast time during standard business hours **- Required** + CCMC (Commission for Case Manager Certification) - a plus - Preferred + Knowledge and ... experience teaching self-management. - Preferred + Exceptional communication skills, both written and oral, ability to positively influence others with respect and compassion; fluency in a foreign language is a plus.- Preferred + Strong work ethic built on a… more
- Intermountain Health (Raleigh, NC)
- …Nurse (RN). Preferred Qualifications + Bachelor's degree in Nursing. + Certified Case Manager (CCM). Relevant certification as determined at position level. ... + 2 years' nursing experience outpatient care. + 1 year Care Management experience. **Physical Requirements:** Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess patient needs. - and… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- Summary The incumbent is a professional social worker assigned as a Social Work Case Manager in the Intensive Community Mental Health Recovery (ICMHR) program. ... The social worker's primary responsibilities are to provide intensive case management services to assigned veterans, consistent with the goals and methods of Mental… more
- Sedgwick (Raleigh, NC)
- …Rehabilitation Counselor (CRC), Certified Disability Management Specialist (CDMS) or Certified Case Manager (CCM) designation preferred. **Experience** Four (4) ... employment positions as requested by referral sources or employers; to assist case management staff with client competence decisions for individual positions; to… more