- Genmab (Berkeley Heights, NJ)
- …provide a positive experience. This position reports to the Patient Services Manager , Call Center Operations.The creation of our new internal Genmab Patient Services ... Office Practice Management or Pharmacy. The ideal candidate has experience in case management, phone-based support work and the health insurance landscape. Patient… more
- Eisai, Inc (Houston, TX)
- …your profile, we want to hear from you. The Access and Reimbursement Manager (ARM) will provide appropriate support for patient access to prescribed Eisai products, ... relevant internal/external stakeholders.Educate external stakeholders (eg, physicians, office administrators, case managers, financial counselors, medical directors, billing personnel, pharmacists)… more
- PharmaCord (Lexington, KY)
- …Acquisition team immediately at ###@pharmacord.com When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the ... cases are handled in a timely manner. An Executive Case Manager has the ability to translate...resolution. Knowledge of healthcare compliance regulations, including HIPAA and Medicare/ Medicaid guidelines. Bi-lingual skills are a plus. We are… more
- Mom's Meals (Ankeny, IA)
- …clinical background, such as registered dietitian, licensed social worker or nursing case manager , with customer relationship experience will be strongly ... or project teams, clinical and operational teams and field-based case managers will be critical for the Manager...healthcare sales experience in areas such as managed care, long -term care, home health, home care, hospital or medical… more
- COOLSOFT (Raleigh, NC)
- …documents, Business use cases, Business case scenarios, user acceptance test case scenarios, and documentation in relation to Medicaid initiatives and ... strategic alternatives for business solutions. - Preferred to have experience with Medicaid , managed care, and Pharmacy Benefit Manager (PBM) operations. areas.… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the daily ... decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of Utilization… more
- Commonwealth Care Alliance (Boston, MA)
- …Licensing (must have):** + RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** + 2 to 3 years ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
- DESC (Seattle, WA)
- …client engagement program, responsible for providing behavioral health, client engagement and case management services to individuals enrolled in Medicaid . This ... **Days Off:** Saturday and Sunday **Insurance Benefits:** Dental, Life, Long -term Disability, Medical (no premiums/payroll deductions for employee coverage) **Other… more
- Commonwealth Care Alliance (Springfield, MA)
- …across various locations. This position reports to the CIC BH Clinical Manager . **Supervision Exercised:** + No, this position does not have direct reports. ... + Facilitating and/or delivering preventative care and behavioral health assessments. + Long Term support for patients with the most significant behavioral health… more
- Commonwealth Care Alliance (Springfield, MA)
- …patient to access the best types of care for their needs including community long -term services and supports. They will focus on reducing gaps in preventive care ... needs. This position reports to the CIC CHW Clinical Manager **Supervision Exercised:** + No, this position does not...department use + Supports patient retention and connection to Medicaid and Medicare benefits + Conducts health education on… more
- MVP Health Care (Schenectady, 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
- New York State Civil Service (New York, NY)
- …detectives, data analysts, and legal support analysts to conduct complex, long -term healthcare fraud investigations. The Medicaid program provides health ... No Agency Attorney General, Office of the Title Legal Nurse: Investigate Medicaid Fraud/Patient Abuse (6400) Occupational Category Legal Salary Grade NS Bargaining… more
- Highmark Health (Dover, DE)
- …LTSS. Provides direct oversight to Case Managers, meets all of the requirements of a Case Manager and be able to assist in the day to day responsibilities of ... a Case Manager as needed. This is a...disabilities population + Two years in home clinical or case management experience + Medicare and Medicaid … more
- Highmark Health (Dover, DE)
- …+ One year in home clinical or case management experience + Certified Case Manager (CCM) + Licensed Bachelors Social Worker (LBSW) + Licensed Masters Social ... working directly with members in their homes and also requires providing case management services within nursing facility settings. The incumbent will travel to… more
- Elevance Health (Indianapolis, IN)
- **Behavioral Health Medical Director - Psychiatrist - Indiana Medicaid ** **Location:** This role enables associates to work virtually full-time, with the exception ... The **Behavioral Health Medical Director** is responsible for reviewing cases for IN Medicaid members including child and substance use disorders, and all levels of… more
- Elevance Health (Woodbridge, NJ)
- **Behavioral Health Medical Director- Psychiatrist- NJ Medicaid ** Location: The successful candidate will be a board-certified psychiatrist licensed and residing in ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- CVS Health (Charleston, WV)
- …Qualified candidates must reside in the region, in one of the following counties: The Case Manager RN (CM RN) is responsible for telephonically and/or face to ... of partnering with the State to provide West Virginia's Medicaid population with top notch health care coordination and...intervention skills * Managed care/utilization review experience * Certified Case Manager (CCM) certification * Case… more
- Humana (Denver, CO)
- …a part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... holistic approach for case management throughout the continuum of care. The case manager will offer guidance, support, and coordination of the beneficiary's… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for you, we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department ... of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP)...Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members… more
- WestCare Foundation (Fort Lauderdale, FL)
- Case Manager Job Details Job Location Fort Lauderdale - 1777 S Andrews Avenue Ste 300 - Fort Lauderdale, FL Position Type Full Time Education Level 4 Year Degree ... Range $21.63 - $21.63 Hourly Description Position Summary: The Case Manager plays a vital role in...services and activities timely in accord with certification, licensing, Medicaid , accreditation standards and agency policy and procedure +… more
