Nurse Case Manager Senior CCMSINurse Case Manager SeniorCarson City, Nevada$90,000–$100,000 / yearThis role serves as a clinical resource to claims professionals, injured workers, employers, and medical providers, while promoting quality care, appropriate treatment, cost-effective medical management, and timely return-to-work outcomes. Successful Nurse Case Managers are collaborative problem-solvers who understand how to balance quality patient outcomes with effective claim management and return-to-work strategies.
APP Manager (NP or PA) - Cardiac OR Vanderbilt University Medical CenterAPP Manager (NP or PA) - Cardiac ORNashville, TennesseeCollaborating with the Director for Advanced Practice and entity AP leadership, the AP manager role includes clinical practice, management of daily operations, fiscal accountability with assigned cost centers, and administrative duties, such as assisting with program development, personnel supervision, management (performance feedback, etc.), quality data and outcome-based performance initiatives. The APP Manager, Cardiac OR (CVOR) is a newly created leadership position responsible for the operational oversight, staffing, and performance management of the Cardiac OR First Assist team , including Advanced Practice Providers (NPs/PAs) and First Assist clinicians (e.g., RNFAs) supporting a high-acuity cardiac surgery program.
Nurse Case Manager - Dayton, OH Paradigm Management Services LLCNurse Case Manager - Dayton, OHDayton, OHThe Case Manager works with insurance carriers, medical care providers, attorneys, employers, and employees, and closely monitors the progress of the injured worker and reports results back to the employer and insurance carriers. We're striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve.
Telephonic Nurse Case Manager Paradigm Management Services LLCTelephonic Nurse Case ManagerTampa, FLProfessional licenses or certifications required to meet qualifications for this position must be current, unrestricted and allow for practice within a state or territory of the United States (TN BWC, GA Rehab Supplier, NC QRP, MD RN WCCM / MCRSP.). We're striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve.
Nurse Case Manager - Charlotte, NC Paradigm Management Services LLCNurse Case Manager - Charlotte, NCCharlotte, NCThe Case Manager works with insurance carriers, medical care providers, attorneys, employers, and employees, and closely monitors the progress of the injured worker and reports results back to the employer and insurance carriers. We're striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve.
New Business Case Management Specialist - Mandarin Speaking National Life Insurance CompanyNew Business Case Management Specialist - Mandarin SpeakingAddison, Texas$18–$27 / hourA typical day finds the Case Manager assessing medical, nonmedical and financial risk factors and determining appropriate rating for life applications, processing applications in workflow management systems, collaborating within a team, and effectively communicating with the agent/agency via phone, email, and CRM. The base pay range for this position is the range National Life reasonably and in good faith expects to pay for the position taking into account the wide variety of factors, including: prior experience and job-related knowledge; education, training and certificates; current business needs; and market factors.
RN Case Manager Utilization Care Management Unity Health InsuranceRN Case Manager Utilization Care ManagementWI$72,500–$90,600 / yearThis role is responsible for review of prior authorization requests for treatment and services, coordination of prior authorization for patients transitioning back to in-network services, technology assessment, research, and collaboration with internal and external customers such as primary care physicians, hospital case managers, home health, and skilled nursing facility staff to achieve optimal patient care. Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.
Bilingual Analyst Case Management Analyst - Field Tampa, FL CVS HealthBilingual Analyst Case Management Analyst - Field Tampa, FLTampa, FloridaAs a Case Manager Analyst you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services. Using care management tools and data analysis, you assess member needs, identify risks, and develop and implement effective care plans.
Case Management Analyst - Field in Will and DuPage Counties, IL CVS Health CorpCase Management Analyst - Field in Will and DuPage Counties, ILIL$21.10–$44.99 / hourAs an Analyst, Case Manager, you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services. You collaborate with internal teams, providers, and external resources to address barriers, improve quality of care, and ensure services align with member benefits.
Case Management Analyst - Field - Northern Virginia CVS HealthCase Management Analyst - Field - Northern VirginiaAnnandale, VirginiaBachelor's Degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling), LMHP, RN/LPN, QMHP, LMSW, LBSW, MSW or BSW. Develops a proactive course of action to address issues presented to enhance the short and long- term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
Utilization Management - Case Manager II (RN) Sarasota Memorial Health Care SystemUtilization Management - Case Manager II (RN)Sarasota, FloridaFull timeWhen potential denials for payment or level of care arise, the UMCM collaborates with the floor ICM staff, Revenue Cycle, involved physicians and/or the Physician Advisors (PA) as needed to attain second level review/approval to effectively overturn the denial or help determine appropriate transition for the patient. UMCM interact extensively with clinical staff throughout the hospital, other ICM staff, physicians, payers, and hospital financial staff in order to achieve appropriate level of care or placement authorizations, and to avoid denials.
Director of Case Management & House Supervisors Minden Medical CenterDirector of Case Management & House SupervisorsMinden, LAFull timeRequired qualifications/skills:- Unencumbered Louisiana RN license or Multi-State license- BSN preferred- 3 years hospital patient-care experience preferred; at least 1 year case management experience- Strong clinical judgment, critical thinking, communication (verbal/nonverbal), teaching, advocacy, cultural sensitivity, computer proficiency, and leadershipIf you’re ready to help drive excellent, coordinated care, apply today for the case management director and house supervisor role. Key responsibilities include leading case management processes, coordinating discharge planning and resource utilization, advocating for patients and families, facilitating collaboration and negotiation across services, and supervising hospital operations as needed to maintain quality outcomes and regulatory alignment.
Case Management Analyst - Field in the West Side of Chicago, IL CVS Health CorpCase Management Analyst - Field in the West Side of Chicago, ILChicago, IL$21.10–$44.99 / hourLocation: West Side of Chicago in Zip Codes; 60612,60624,60644,60651 (Elmwood Park, Oak Park, Forrest Park - Within 5-7 Miles of these locations/zip codes). As an Analyst, Case Manager, you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services.
Bilingual Case Management Analyst - Field in Miami-Dade County, FL CVS HealthBilingual Case Management Analyst - Field in Miami-Dade County, FLFloridaAs a Case Manager Analyst you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Case Management Analyst - Work at Home NY CVS Health CorpCase Management Analyst - Work at Home NYNY$21.10–$44.99 / hourThis role conducts psychosocial assessments, identifies member needs, develops and implements person-centered service plans, coordinates long-term services and supports, and facilitates access to medical, behavioral health, and community resources. The Care Manager collaborates with members, caregivers, providers, and interdisciplinary teams to promote member independence, improve health outcomes, address social determinants of health, and ensure the delivery of quality, cost-effective care.
Bilingual Case Management Analyst - Field in Miami-Dade, Florida CVS Health CorpBilingual Case Management Analyst - Field in Miami-Dade, FloridaMiami, FL$21.10–$40.90 / hourAs a Case Manager Analyst you support optimal member health outcomes by coordinating care, providing education, and facilitating access to appropriate healthcare services. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
RN - Case Management Talented Medical SolutionsRN - Case ManagementLodi, CA$2,940–$2,943By providing frequent feedback and consistently measuring progress, we’ve discovered the recipe for success that’s delivered year over year growth since our first year of business. On-site role based in Lodi, CA — work directly from our local office and be part of the team on location.
CCM Case Management RN Oscar Health InsuranceCCM Case Management RNFlorida, PRRemote$32.60–$42.79 / hourAbout the role: Telephonic case management role in which you will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with the Clinical Concierge Specialist and other Oscar teams to ensure exceptional care for our members. Work with non-clinical teammates in assisting members to navigate the healthcare system, including coaching non-clinicians on how they can add value to all member interactions.
Case Management Coordinator Sierra TucsonCase Management CoordinatorTucson, ArizonaMonitor and manage client/patient/resident’s cases through development and implementation of individual care plans, collecting clinical data and remain informed by continuous review of documentation. Convey medical criteria and clinical information between the client/patient/residents’ insurance provider and treatment team as warranted and may also provide this information to the business office, as needed.
Nurse Case Manager Cunningham Children's HomeNurse Case ManagerUrbana, IllinoisLocated in Urbana, IL, Cunningham Children's Home is a non-profit agency dedicated to offering support to youth and families, and are committed to the values of spirituality, teamwork, integrity, and respect—if those align with what you’re looking for in an employer, we encourage you to apply to be a part of our Health Services Team! Founded in 1895, Cunningham Children’s Home is a leading child welfare and educational services agency, supporting more than 977 youth and families each year through residential treatment, special education, and community-based programs.