4236 care manager jobs found

Point32Health, Inc. Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about...

Point32Health, Inc. Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about...

CareFirst BlueCross BlueShield Resp & Qualifications MD-DC-Northern VA PURPOSE: Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to optimal health and cost-effective outcomes. This position will support the Federal Employee Program line of business. We are looking for an experienced professional to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with members, family and providers...

CareFirst BlueCross BlueShield Resp & Qualifications Maryland/ DC/ Northern VA PURPOSE : Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to optimal health and cost-effective outcomes. This position will support the Federal Employee Program line of business. We are looking for an experienced clinician to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with member, family and providers to...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: a { text-decoration: none; color: #464feb;}tr th, tr td { border: 1px solid #e6e6e6;}tr th { background-color: #f5f5f5;} This role supports the Dual Special Needs Population (DSNP) in Maryland. Under minimal supervision, the Care Manager conducts thorough research and analysis of members medical and behavioral health needs, along with the key drivers influencing healthcare utilization and costs. The Care Manager partners closely with members and the interdisciplinary care team to develop and implement person-centered plans of care that promote a positive member experience, improved health outcomes, and costeffective service delivery. We are seeking a bilingual Care Manager to enhance communication, cultural responsiveness, and engagement with our diverse DSNP member population. This position is remote, with the expectation that the selected candidate resides within the greater Baltimore metropolitan area....

CareFirst BlueCross BlueShield Resp & Qualifications (Maryland-DC-Northern VA) PURPOSE: Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to optimal health and cost-effective outcomes. We are looking for an experienced professional to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with member, family and providers to develop a comprehensive plan of care to address the members needs at...

Point32Health, Inc. Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about...

Point32Health, Inc. Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about...

Riverside Community Care Riverside Community Care Love what you do! Nurse Care Manager / Registered Nurse – Behavioral Health Community Partners Riverside is seeking a Registered Nurse to join our growing Behavioral Health Community Partners (BH CP) team for a hybrid position based out of our Needham area office. We have a unique opportunity to expand your experience on an interdisciplinary team and coordination with clients living with psychiatric or mental diagnosis. The BH CP team provides services to people served within in the community. In this exciting position, you will be part of a multi-disciplinary team, collaborating with behavioral and medical health providers all working to link eligible Masshealth consumers to community-based resources and to reduce barriers to these consumers engaging in appropriate community-based services. The Nurse Care Manager will provide, oversight of medication reconciliation, review and collaboration on assessments,...

Kaiser Permanente Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge and issuing denial letters. With primary care, specialist physicians and healthcare team, coordinates the implementation of a chronic disease care management program for patients. Coordinates with the assigned physician to manage Skilled nursing patients and directs families, patients, physicians, nurse practitioners and SNF staff to the appropriate level of care and identifies those patients who do not meet the criteria for Continued Skilled stay. Responsible for managing Custodial patients who require long term care for chronic disease management in SNFs. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team. Essential Responsibilities: In conjunction with physicians and...

Kaiser Permanente Job Summary: In addition to the responsibilities below, this position is also responsible for implementing best practice models; implementing patient care delivery systems and practice standards in one or more locations; investigating and resolving patient/family/member concerns regarding patient care and services; collaborating with physicians, outside healthcare providers, and other health care team members to achieve optimal and safe patient care across the continuum; monitoring resource needs in assigned clinical areas to ensure appropriate assignment and utilization; monitoring the use and maintenance of equipment, supplies and medications; fostering a safe environment for patients and employees; maintaining clinical expertise of self and/or team, providing clinical supervision, competency and licensing necessary to fulfill job responsibilities and to direct the provision of care in the unit; delegating tasks and duties that are aligned to scope of...

Kaiser Permanente Job Summary: Provides mental health assessment, diagnosis, treatment and crisis intervention services for adult and/or child members who present themselves from psychiatric evaluation with a broad range of mental health needs. Collaborates with treating physician, psychiatric and allied health professional team to plan and direct each individual member treatment program. Essential Responsibilities: Develops, implements, coordinates, and evaluates clinical treatment programs for the diagnosis, treatment, and/or referral of Health Plan members with acute or chronic mental illness. Participates in staff conferences to select, plan, and evaluate treatment programs. Provides outpatient psychotherapy to individuals, couples, families and groups. Instructs and counsels patients and their families regarding compliance with prescribed therapeutic regimens and adherence to prescribed medication regimens, within the scope of practice. May administer...

Who we are At Teva, we’re proud to be a leading innovative biopharmaceutical company, enabled by a world-class generics business. Fueled by our purpose, “we are all in for better health” and desire to be a leader in CNS, we’re dedicated to addressing patients’ needs, now and in the future. As we strive to improve access and outcomes for patients across all points of care, we’re thoughtfully expanding our US sales teams. Sales professionals at Teva are part of a purpose-driven organization with a uniquely diverse portfolio and a promising pipeline focused on core therapeutic areas. We’re investing in research, marketing, and innovation - empowering our teams to deliver patient-centric solutions that truly make a difference. If you’re ready to join a company that values your contribution and supports your growth, Teva offers the platform to bring better health solutions to patients and providers so we can address the most pressing challenges throughout the treatment journey....

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We're hiring for a Manager, Data Analytics - Value-Based Care Reporting on the Health Economics and Reporting team at CareFirst! Purpose of the Manager, Data Analytics is to execute business objectives with data and ensure alignment with the vision of the company. Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction. We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Purpose of the Manager, Data Analytics is to execute business objectives with data and ensure alignment with the vision of the company. Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. We are not looking for...

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING! Strategic Staffing Solutions is currently looking for an RN Case Manager for a contract opportunity with one of our largest healthcare clients! Title: RN Case Manager - Compact License Duration: Long-term contract with opportunity to convert to FTE Location(s): Remote (Compact States) Pay Rate: $38-40/HR *100% remote - must reside in a state that is part of the Nurse Compact (multi-state-licensure) Accepted states: Colorado Georgia Indiana Kentucky Mississippi Virginia Washington State Louisiana Iowa Requirements: Must have diverse case management experience; hospice, hospital, home care, medical (acute care, ER, ICU, Med-surg, etc.). Case management experience Must have multi state compact license ROLE SUMMARY The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management...

Kaiser Permanente Job Summary: Provides case management services to a caseload of low- and medium-risk patients. Interviews patients and their caregivers to evaluate needs, goals, and current services. Proposes process improvements for determining initial eligibility, benefits, and education for all admissions, leveraging advanced knowledge to assess medical necessity and required level of care to inform physicians. Analyzes and ensures authorization data and escalates inaccuracies. Develops a client-focused case management plan in collaboration with healthcare team, patient, and caregivers that is consistent with regulatory, accreditation, and regional guidelines. Assists patients with gaining access to care based on their needs, making referrals as appropriate. Coordinates resources and services to assure continuity and quality of care. Attends case management rounds with clinician and updates authorizations and diagnoses as needed. Assesses patient progress toward treatment...