Clinical Appeals Coordinator LPN/RN Job (Metairie, LA, US)
Description:GENERAL SUMMARYResponsible for coordinating grievance appeals activity and ensuring compliance with State and Federal regulations and accrediting bodies.ESSENTIAL RESPONSIBILITIES-...
View ArticleBehavioral Health Case Mgr Job (St. Louis, MO, US)
Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...
View ArticleSocial Workers Needed for the Orange, Osceola, Brevard and Seminole Counties...
Description:GENERAL SUMMARYFunctions as a coordinator of care for members identified as having long-term rehabilitation and/or psychosocial needs as a result of birth defects, chronic conditions,...
View ArticleOutreach Coordinator Job (Erie, PA, US)
Description:GENERAL SUMMARY Coordinates member and provider outreach to ensure effective use of health plan benefits and to improve member health outcomes within the Medicaid or Medicare population....
View ArticleComplex Discharge Planner Job (Casselberry, FL, US)
Description:GENERAL SUMMARYResponsible for working with high risk members who have been admitted to a clinical care facility to identify those with specific behavioral health needs requiring intensive...
View ArticleOutreach Coord, HEDIS Job (Wichita, KS, US)
Description:GENERAL SUMMARYFacilitates provider and member outreach to ensure member receipt of important clinical services to improvement member health outcomes. Provides support for Healthcare...
View ArticleClinical Appeals Nurse Job (Morrisville, NC, US)
Description:Coventry Health Care of the Carolinas, Inc. has an immediate opening for a Clinical Appeals Nurse in our Morrisville, NC office.GENERAL SUMMARYResponsible for coordinating grievance appeals...
View ArticleBehavioral Health Case Manager Job (Louisville, KY, US)
Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...
View ArticleBehavioral Health Case Manager Job (Louisville, KY, US)
Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...
View ArticleBehavioral Health Case Manager Job (Louisville, KY, US)
Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...
View ArticleOutreach Coord - Temporary Part-Time (20 hours) Job (Atlanta, GA, US)
Description:GENERAL SUMMARYThis is a temporary part-time position (20 hours) with an approximate completion date in December. The successful candidate will coordinate member outreach to ensure...
View ArticleTelephonic Complex Case Mgr - RN Full Time Job (St. Louis, MO, US)
Description:GENERAL SUMMARYTransitional Care Case Manager will function as the central point of contact for a short term transitional care program targeted at inpatient members at a high risk for...
View ArticleRN Case Manager - Home Visits Job (Richmond, VA, US)
Description:NEW OPPORTUNITY - COMPLEX CASE MANAGERCo-Morbid Case Management (CMCM) is an Enhanced Care Management Program focusing on high risk, co-morbid aged; blind and disabled Medicaid members...
View ArticleComplex Case Mgr Job (Overland Prk, KS, US)
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members identified as having chronic disease processes or for members in select physician practices. Responsible for...
View ArticleComplex Case Mgr Job (Scottsdale, AZ, US)
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members/injured employees identified as having chronic disease processes or for members/injured employees in select physician...
View ArticleComplex Case Mg, Behavioral experience a Plus! Job (Louisville, KY, US)
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members identified as having chronic disease processes. Responsible for implementing and coordinating all case management...
View ArticleComplex Case Mgr Job (San Antonio, TX, US)
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members/injured employees identified as having chronic disease processes or for members/injured employees in select physician...
View ArticleOutreach Coord Job (Morrisville, NC, US)
Description:GENERAL SUMMARYCoordinates member outreach to ensure effective use of health plan benefits and to improve member health outcomes within the Medicaid or Medicare population. Responds to...
View ArticleObstetrics or Pediatric Complex Case Mgr Job (Louisville, KY, US)
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members primarily with complex pregnancy conditions in select physician practices or pediatric cases. Responsible for...
View ArticleComplex Case Mgr with Pediatric Foster Care Experience valuable! Job...
Description:GENERAL SUMMARYFunctions as the central coordinator of care for members identified as having chronic disease processes or for members/injured employees in select physician practices....
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