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Ideal candidates have pediatric / foster care case management experience and are located in the areas of New Port Richey, Tampa, Orlando, Maitland, Sarasota, and Fort Myers. Ideal candidates have child welfare / foster care case management experience.
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Position Purpose: Manages the LTSS Nurses team to develop and assess high quality, cost-effective healthcare outcomes.
$183,100 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Develops strategies and objectives within care management to improve member and/or provider experience. Position Purpose: Directs the care management team and the care (management) of members to develop and assess high quality, cost-effective healthcare outcomes.
$216,200 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Manages utilization management issues related to member care, provider interactions, and facilitates operations within utilization management. Position Purpose: Manages Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members.
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7+ years of vendor management experience, including government programs health care or related experience in multiple areas of operations. Manage utilization management clinical vendor relationships to drive value for Centene and to ensure the vendor is complying with established internal and/or regulatory performance metrics.
$263,500 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Leads and develops strategies and objectives within care management to improve member and/or provider experience. Leads and directs the care management team and the care management of members to develop and assess high quality, cost-effective healthcare outcomes.
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Oversees care management teams' facilitation of member and provider needs through the complete care management cycle. Supports in developing the overall strategy for onboarding, hiring, and training new care management team members.
$183,100 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Supervises day-to-day escalations and care management issues related to members or providers. Supervises the care management team and the care management of members to promote quality and efficacy of care management delivery.
$155,000 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Collaborates with utilization management team to resolve complex care member issues. Position Purpose Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members.
Full-timeExpandApply NowActive JobUpdated 29 days ago - UpvoteDownvoteShare Job
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Monitors audits within care management to ensure compliance with regulatory requirements for federal, state, and National Committee for Quality Assurance (NCQA) standards, as required. Position Purpose Manages the care management team that serves long-term care members with physical/medical health needs and/or behavioral/mental health needs to develop and assess high quality, cost-effective healthcare outcomes.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Position Purpose Works with care management team on administrative care management activities including performing outreach, answering inbound calls, and scheduling services.
$33.36 an hourFull-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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For Health Net Federal Services (Medical Management) Certified Managed Care Nurse (CMCN) within 1-1/2 Yrs required. Assists with onboarding, hiring, and training utilization management team members.
$130,100 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service. Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service.
$26.97 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Assists utilization management senior leadership with onboarding, hiring, and training utilization management team members. Ideal candidate will have experience in utilization management, provider and payor side with 2-5 years of leadership experience.
$155,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Health care actuary that has experience in Medicare, Medicaid or ACA line of business. Highly preferred experience, but not required Health care actuary that has experience in Medicare, Medicaid or ACA line of business.
$239,300 a yearFull-timeExpandApply NowActive JobUpdated Today
care management jobs Title: management Company: Centene Corporation in Rogers, Arkansas
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