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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Must have a Compact Multi-State RN License
Day and Night Shift Available
Position Purpose: Triage inbound calls, ga...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Assist with aspects of...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
The ideal candidate should have behavioral health clinical experience and expertise in designing clinical a...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
The ideal candidate should have chronic conditions clinical experience and expertise in designing clinical ...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Works with members and providers to close care gaps, ensure barriers to care are removed...

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choo...

Become a part of our caring community and help us put health first
The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination o...

Current University of Arkansas System employees, including student employees and graduate assistants, need to log in to Workday via MyApps.Microsoft.com , then access Find Jobs from the Workday search bar to view and apply for open positions. Students at University of Arkansas System two-year institutions will also view open positions and apply within Workday by searching for “Find Jobs for St...

Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job provides case and condition management services to pediatric members with behavioral health concerns and their families. The incumbent has experience with the pediatric population and uses clinical and motivational interviewing skills to assess members’ needs and establish mutually agreeable short and long-term goals. Suppor...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
MUST RESIDE IN THE WEST CALIFORNIA AREA
Registered Nurse Strongly Preferred
Position Purpose: Perform...

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important...

Become a part of our caring community and help us put health first
Humana is seeking a Quality Audit/Improvement Professional who will audit and monitor quality improvement programs for Humana’s Indiana Pathways and LTSS program. The Quality Improvement Professional’s work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of...

This is a remote position supporting Louisiana. Candidates must be licensed and reside in Louisiana.
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge plannin...

About CareScout
Join us on a mission to simplify and dignify the aging experience. We are the children, siblings, neighbors, and friends of those navigating the fragmented and confusing system of long-term care. Our team is ferociously curious and relentless in our pursuit of a better system - and we are deeply committed to a sense of belonging for all, in all phases of life.
We're creating a n...

Company :
Highmark Health
Job Description :
JOB SUMMARY
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monit...