• Case Manager , Medicaid

    MVP Health Care (Tarrytown, NY)
    …requires innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to ... Case Management experience. Experience working in a Medicaid Long Term Support Program (LTSS) or... Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and… more
    MVP Health Care (11/29/25)
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  • Case Manager Registered Nurse…

    CVS Health (Wayne, NJ)
    …**Schedule:** Standard business hours Monday-Friday 8:00am-5:00pm EST. **Position Summary** The ICM Case Manager develops a proactive plan of care to address ... identified issues to enhance the short and long -term outcomes as well as opportunities to enhance a...within Morris County, New Jersey. **Preferred Qualifications** + Certified Case Manager is preferred. + Minimum 2+… more
    CVS Health (11/24/25)
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  • Case Manager RN - Field - Passaic…

    CVS Health (Montclair, NJ)
    …close to or within Passaic County, New Jersey **Preferred Qualifications:** + Certified Case Manager is preferred. + Minimum 2+ years Care Management, Discharge ... on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex...are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical… more
    CVS Health (11/27/25)
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  • Provider Network Manager Sr (US)

    Elevance Health (Middletown, NY)
    …Primary focus will be, but not limited to: contracting and negotiating Single Case Agreements. Typically works with the most complex providers. Complex providers may ... immunotherapy contracting experience. + Commercial, Medicare, and / or Medicaid contracting experience. + Strong negotiation skills, critical thinking, analytical… more
    Elevance Health (11/21/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Yonkers, NY)
    …Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... denial decisions. * Resolves escalated complaints regarding utilization management and long -term services and supports (LTSS) issues. * Identifies and reports… more
    Molina Healthcare (11/14/25)
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