- Somatus (Philadelphia, PA)
- …service Preferred Qualifications: + BSN or higher level of education + Certified Case Manager (CCM) + Diabetic Educator experience + Field-based experience going ... into homes + Telephonic case management experience + Experience working within a managed care environment **Hourly Range** $85,000 to $97,000 per year… more
- Sedgwick (Harrisburg, PA)
- …a Great 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… more
- CVS Health (Harrisburg, PA)
- …care for members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- Humana (Harrisburg, PA)
- …degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see Language Proficiency ... community and help us put health first** The Care Manager , Telephonic Nurse 2, in a ...homes. Our nurses are titled Care Managers, because our case management services are centered on the person rather… more
- UPMC (Pittsburgh, PA)
- …be a perfect fit for you! UPMC Health Plan is hiring a full-time Pediatric Telephonic Care Manager to support the Medical Management Medicaid team. This position ... of downtown Pittsburgh, but team members may reside anywhere in Pennsylvania. The Telephonic Care Manager is responsible for care coordination and health… more
- AmeriHealth Caritas (Philadelphia, PA)
- …Experience with behavioral health desired + Minimum of three years of experience as a case manager , preferably providing telephonic case management + ... about us at www.amerihealthcaritas.com . **Role Overview** The Care Manager (RN) assists members appropriate for case ...Certification as a case manager preferred **Skills and Abilities** + Proficiency using MS… more
- Sharecare (Harrisburg, PA)
- …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 members, caregivers, providers, and the interdisciplinary...preferred. + Minimum 3-5 years varied clinical experience with telephonic Case Management experience strongly preferred. +… more
- UPMC (Pittsburgh, PA)
- …Insurance + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Certified Case Manager (CCM) + Driver's License + Registered Nurse (RN) + ... use your nursing background in outpatient, home health, or case management? Do you have an interest in health...UPMC Health Plan is hiring a full-time Clinical Care Manager to support our partnership with various physician practices.… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan is seeking a full-time Professional Care Manager , Supervisor to join our Utilization Management (UM) Clinical Operations team. This position follows ... responsible for oversight and day-to -day care coordination functions for telephonic , clinical, or utilization management care management staff, including the direct… more
- AmeriHealth Caritas (Norristown, PA)
- …an acute care, home care, or special needs clinic + 3+ years of Case Management experience, preferably telephonic within a managed care organization, desired + ... **Role Overview** The Community Care Manager assists members appropriate for care management and...Eligible to sit for Case Management certification after 12 months of employment. Must… more
- CVS Health (Harrisburg, PA)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress,… more
- ICW Group (Philadelphia, PA)
- …department and vendors. + Acts as a gatekeeper for referrals between in-house telephonic nurse case managers, claims examiners and vendors. Reviews open ... bill review, case management and utilization review. + Works closely with Case Management Manager and Director to perform quarterly reporting on program… more
- Sharecare (Harrisburg, PA)
- …days of training. PTO needs during the training period will be evaluated on a case by case basis and must be approved in advance._ **Compensation:** $18.00/hour ... (non-negotiable) Under the general supervision of the Operations Manager , the Outreach Specialist has the primary responsibility of scheduling members for enrollment… more
