- Staffing Solutions Organization (Augusta, ME)
- …which is a reflection of our clients and the people they serve. ** Care Coordination Nurse in Augusta, ME ( Remote )** **This position can be Remote ... As a Registered Nurse , you will work closely with existing care coordination capacity in the community to maximize the efficient use of state resources… more
- Sharecare (Augusta, ME)
- …July 21st, 2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care ... and efficient manner by providing high-quality telephonic Case or Care Management with CareFirst members. The Care ...based on member need. + Assist the member in coordination of any additional tests, images and consults with… more
- Public Consulting Group (Augusta, ME)
- …within the State to conduct periodic in-person assessments * Facilitates multiple care aspects (case coordination , information sharing, etc.) * Helps patients ... to conduct periodic in person assessments + Facilitates multiple care aspects (case coordination , information sharing, etc.)...Proven working experience in case management, including as a nurse , medical, mental health care manager or… more
- Public Consulting Group (Augusta, ME)
- …within the State to conduct periodic in person assessments + Facilitates multiple care aspects (case coordination , information sharing, etc.) + Helps patients ... and on a team. + Proven working experience in case management, including as a nurse , medical, mental health care manager or a related job + Excellent knowledge… more
- CVS Health (Augusta, ME)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... reside in EST time zone.** This is a full-time remote position. + Utilizes clinical experience and skills in...judgment to render coverage determination/recommendation along the continuum of care + Communicates with providers and other parties to… more
- Centene Corporation (Augusta, ME)
- …medication review for pre-admission and post-discharge reconciliation. Works with the care management and coordination teams to identify transition support ... workplace flexibility. **MUST RESIDE IN THE STATE OF MAINE** **Registered Nurse Strongly Preferred** **RN Compact License/Multi-State License a Plus** **Position… more
- Zurich NA (Augusta, ME)
- …Insurance is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position, offering the flexibility of a home-based office. As the AVP of ... clinical services for the determination of medical necessity and appropriateness of care of our insureds' injured employees. You will develop, recommend and execute… more
- Humana (Augusta, ME)
- …the efficient use of healthcare resources while maintaining high-quality patient care . **Cost Containment:** + Identify opportunities for cost savings through ... to ensure cohesive utilization management practices. + Facilitate communication and coordination between different departments + Point of contact to strategize and… more
- Humana (Augusta, ME)
- …(RFPs), including mapping UM components for new state bids. + Oversight and coordination of DSNP strategy and programs **Use your skills to make an impact** ... **Required Qualifications** + Registered nurse (RN) with unrestricted licensed **OR** independent licensed clinical social worker + 2-5 yrs of previous senior… more
- Highmark Health (Augusta, ME)
- …participate in departmental strategic planning, goal setting, and initiative coordination . Lead process improvement projects annually to optimize clinical sales ... **Required** + 7 years in a clinical or Managed Care setting **Preferred** + 5 years Client Support +...or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant… more