- Public Consulting Group (Santa Fe, NM)
- …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
- Sedgwick (Santa Fe, NM)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy,… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Job Description** The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to ... field + Background in advocacy, counseling, nursing, or social work + Case management experience in the specific therapy area + Bilingual skills, particularly… more
- Public Consulting Group (Santa Fe, NM)
- …that is safe, timely, effective, efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine ... to conduct periodic in person assessments + Facilitates multiple care aspects ( case coordination, information sharing, etc.) + Helps patients make informed decisions… more
- Highmark Health (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …+ 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
- Cardinal Health (Santa Fe, NM)
- …+ Must demonstrate a superior willingness to help external and internal customers + First point of contact on inbound calls, and determines needs, and handles ... Cardinal Health Sonexus (TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma,… more
- Travelers Insurance Company (Santa Fe, NM)
- …with insured based on application of policy information to facts or allegations of each case . + Work with Manager on use of Claim Coverage Counsel as needed. ... statements, as strategically appropriate. + Complete outside investigation as needed per case specifics. + Travels frequently inclusive of claim office visits, court… more
- Molina Healthcare (Santa Fe, NM)
- …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP),… more
- Molina Healthcare (Santa Fe, NM)
- …health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) **Bilingual (Spanish)** **WORK SCHEDULE:** ... of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial… more
- Jet Health (Santa Fe, NM)
- …promptly. If unable to perform a certain task, report to the Registered Nurse Case Manager immediately + Meeting safety needs of patient and using equipment ... + Reporting on patient's condition and significant changes to the Registered Nurse Case Manager . Also aware of the caregiver or other individuals living with the… more
- LifePoint Health (Los Alamos, NM)
- …appropriate medical diagnostic and treatment skills. Coordinates discharge planning with Case Manager for admitted patients. Documents patient care performed, ... assessments made, and orders given. Recommends, participates in, and actively works to ensure the success of efforts to improve cost effectiveness of care provided to patients throughout the organization. Accepts patient referrals from other physicians. Acts… more
- Fresenius Medical Center (Santa Fe, NM)
- …another staff member present + Position functions as an onsite Patient Educator and Case Manager for patients with various shifts and work hours **EOE, ... This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. Assesses and manages patients' response to home dialysis… more
- Cardinal Health (Santa Fe, NM)
- …helps manufacturers rethink how far their products can go. **Accountabilities** 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, investigating… more
- Molina Healthcare (Santa Fe, NM)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... Professional in Healthcare Quality + other healthcare certification To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and… more
- Sumitomo Pharma (Santa Fe, NM)
- …highly motivated, and experienced individual for the position of **Associate Manager , Compliance, Training & Strategic Alliance (CTSA), PVRM** . The Associate ... Manager , Compliance, Training & Strategic Alliance (CTSA), PVRM is...compliance issues and significant quality issues originating with the case processing vendor and License Partner. + Participate in… more
- Datavant (Santa Fe, NM)
- …vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the Business Analytics team and ... of its analysts. We are looking for a hands-on manager who has experience and interest in providing guidance...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Datavant (Santa Fe, NM)
- …in healthcare. **Role Summary:** We're looking for a Staff Product Marketing Manager who thrives at the intersection of product, customer, and commercial strategy. ... and proof points of our products. Each Product Marketing Manager is responsible for being a product and market...for the product lines in your vertical (in this case , the Provider product vertical). That requires you to… more
- Sharecare (Santa Fe, NM)
- …2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program ... in an appropriate and efficient manner by providing high-quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- Datavant (Santa Fe, NM)
- …realize our bold vision for healthcare. We are looking for a Health Information Operations Manager that will be the tip of the spear for our service offering. Our ... outcomes. **You will:** + Serve as the primary Account Manager to our customers + Mentor and develop hourly...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more