- Healthfirst (TN)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... **This position is 100% Remote **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
- Highmark Health (Nashville, TN)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Summary: Vanderbilt University Medical Center (VUMC) is accepting applications for the Case Manager role within our Transition Management Office (TMO). The ... through preeminent programs in patient care, education, and research. **Organization:** TMO/ UM Team E **Job Summary:** JOB SUMMARY Collaborates with the health… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Summary: Vanderbilt University Medical Center (VUMC) is accepting applications for the Case Manager role within our Transition Management Office (TMO). The ... through preeminent programs in patient care, education, and research. **Organization:** TMO/ UM Team E **Job Summary:** JOB SUMMARY Collaborates with the health… more
- Catholic Health Initiatives (Hixson, TN)
- …is required. Preferred + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred Required Minimum Knowledge ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Healthfirst (TN)
- …with demonstrated ability to handling rapidly changing crisis situations + Knowledge of UM /QM case philosophies and reporting requirements to state and federal ... agencies + Ability to allocate, monitor, and control resources while delegating and monitoring workloads + Ability to effectively manage performance as well as set and achieve goals **Compliance & Regulatory Responsibilities:** + Ensures Care Management team… more
- Sharecare (Nashville, TN)
- …hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management ( UM ) status, including but not limited to medical, dental, and vision ... members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: +… more