Las Vegas, Nevada
Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and cli...
9d
RN Community Based Care Manager
Macon, Georgia
Job Summary: The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports a...
9d
Community Based Care Manager - RN or SW - Nevada
Las Vegas, Nevada
Job Summary: The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports a...
9d
Mesquite, Nevada
Job Summary: Priority will be given to those located in Elko, then Lyon and Nye Counties. The Manager, Rural Health is responsible for overseeing the Tribal and Rural Health Programs aimed at enhancing healthcare accessibility, quality, and...
9d
Dayton, Ohio
Job Summary: The Clinical Appeals Nurse is responsible for processing clinical appeals and attending state hearings within compliance and regulatory standards, clinical guidelines, and contractual obligations. Essential Functions: Responsib...
9d
Director, Network Development and Engagement(Military Program Experience Preferred)
Jacksonville, Florida
Job Summary: This position supports TRICARE Prime Demo by CareSource Military & Veterans, which aims to enhance healthcare access and prioritize the unique needs of the military community. We encourage military affiliated individuals, veter...
9d
Dayton, Ohio
Job Summary: The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and cli...
9d
Dayton, Ohio
Job Summary: The Associate Vice President, Care Management is responsible for the strategic leadership and operational oversight of health plan and clinical services. This role involves developing and implementing innovative programs that e...
9d
TL, Utilization Management - MSL with UM experience (PST Hours required)
Las Vegas, Nevada
Job Summary: The Team Lead, Clinical Care Review is responsible for providing direct oversight of Clinical Care Review (CCR) employees and overseeing day-to-day workflow within the CCR team. Essential Functions: Provide direct oversight of ...
9d
Mom & Baby Care Manager RN - Must reside in Nevada
Las Vegas, Nevada
Job Summary: The Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the populatio...
9d