Remote Episodic Care Manager Medicare Utilization

$73.7k - $117.92k

Blue Cross and Blue Shield of North Carolina

Blue Cross and Blue Shield of North Carolina is seeking an Episodic Care Manager to join the Medicare Utilization Management Team. The role involves coordinating health care services and performing clinical reviews for members. Candidates should be RNs with 3 years of experience or LPNs with 5 years. This position offers hybrid and remote options, contributing to a flexible work environment while ensuring quality patient care. The salary range is $73,698.00 - $117,917.00, along with comprehensive benefits. #J-18808-Ljbffr

Apply

Vacancy posted 23 hours ago

Similar jobs that could be interesting for youBased on the Remote Episodic Care Manager Medicare Utilization in Durham, NC vacancy

Episodic Care Manager
$73.7k - $117.92k
## Episodic Care ManagerApplylocations: Remote Flex - North Carolina: Hybrid Flex - Durhamtime type: Full timeposted on: Posted Yesterdaytime... ...Description**We're hiring an Episodic Case Manager to join the Medicare Utilization Management Team! The Episodic Care Manager is...
Remote work
Work at office
Local area
Flexible hours
2 days per week
Blue Cross and Blue Shield of North Carolina
Durham, NC
1 day ago
Remote RN: Utilization Review & Care Manager
...healthcare provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN... ...providers. This position offers the flexibility of remote work while supporting professional growth and...
Remote work
Guidehealth
Chicago, IL
5 days ago
Care Manager - Utilization Management (Must Have UAS Experience)
...Overview Empower. Unite. Care. MetroPlus Health i... ...you do every day. The Care Manager, under the direction of the... ...established MetroPlusHealth Utilization Management policies, procedures... ...Knowledge of computer systems. #LI-REMOTE #MPH-50
Remote work
MetroPlusHealth
New York, NY
3 days ago
Utilization Management Care Manager
$58.66k - $142.45k
...for-profit, we support patient care, research, teaching, and... ...and much more. The UMCM will utilize clinical knowledge to analyze,... ...outpatient review) experience in a managed care setting with Medicaid/MassHealth... ...Working Conditions This is a remote role with occasional onsite...
Remote work
Work at office
Flexible hours
Shift work
Santa Barbara Cottage Hospital
New York, NY
3 days ago
Remote Care Manager - Mental Health Utilization & Discharge
Magellan Health, Inc. is seeking a remote Louisiana Licensed Care Manager to support mental health and substance abuse services. You will monitor inpatient... ...in collaborating with clinical teams to ensure effective utilization of care. #J-18808-Ljbffr Magellan Health, Inc.
Remote job
Magellan Health, Inc.
New York, NY
2 days ago
Care Manager
...medically complex Medicare beneficiaries who... ...facilities, board and care facilities and at... ...As the Care Manager RN or LVN for CCMD... ...be responsible for utilizing your clinical expertise... ...the treatment episode at all levels of care... ...Mesa, CA) and remote work Monday to...
Remote work
Work at office
Local area
Monday to Friday
Flexible hours
CareConnect Health Services Inc
Costa Mesa, CA
11 days ago
Behavioral Health Utilization Care Manager
$27.72 - $46.2 per hour
...Day Job Category: Clinical Care Banner Health was recognized... ...is an integrated network for Medicare and private health plans. Known... ...BPN. As a Behavioral Health Utilization Care Manager, you will be assigned to... ...work location will be entirely remote. This position does require...
Remote work
Full time
Work experience placement
Work at office
Monday to Friday
Shift work
Banner Health
United States
21 hours ago
Remote Utilization Review Case Manager
...Quorum Health is seeking a Case Manager - Utilization Review Specialist for a remote role. The Specialist will manage admission reviews, conduct appeals, and identify workflow improvements. This position requires a current RN license and significant experience in healthcare...
Remote work
Quorum Health
Brentwood, TN
1 day ago
Remote Chronic Care/RTM Manager
$10 per hour
...healthcare delivery from reactive, episodic care to proactively managed patient care that prevents life‑changing... ...the Nurse Chronic Care Coordinator, Remote will perform telephonic encounters... ...they are assigned. Harris CCM utilizes a productivity‑based pay structure and...
Remote work
Full time
Contract work
Part time
For contractors
Work at office
Home office
Flexible hours
Harris Computer
New York, NY
2 days ago
Care Manager II (Full Time, Mecklenburg County, North Carolina Based)
$68.23k - $88.7k
...Care Manager II (Full Time, Mecklenburg County, North Carolina Based)... ...based on risk stratification. Utilize person‑centered planning, motivational... ...of the member. Open new episodes in JIVA and schedule initial... ...schedules including hybrid/remote options. Paid time off including...
Remote work
Full time
Work at office
Flexible hours
Alliance
Charlotte, NC
5 days ago
RN, Case Manager, Hospice (FT, Home-Based, M-F, 8am-4:30pm)
...skilled professional nursing care to them, their families... ...with the Hospice Medicare Conditions of Participation... ...with pain and symptom management interventions preferred... ...throughout the episode of care. Displays a willingness to utilize problem-solving techniques...
Remote work
Work experience placement
Work at office
Work from home
Allied Services Integrated Health System
United States
4 days ago
Remote Senior Utilization Review Lead — Eating Disorder Care
...Provider Services is seeking a Senior Utilization Review Specialist to provide administrative support and management for our telehealth services. This remote role involves collaboration with... ...have experience in a higher level of care eating disorders setting, specifically...
Remote job
Within Health Provider Services
New York, NY
3 days ago
Clinical Care Manager - Home Health Care - Full Time
$89.57k - $139.25k
...Clinical Care Manager - Home Health Care - Full Time page is loaded##... ...Lippincott - 301 Lippincott Drive**Remote Type:**On-Site**Employment... ...plan reviews and identify episode changes* **Teach care planning... ...and nursing practice standards utilizing clinical expertise, nursing...
Remote work
Full time
Temporary work
Part time
Local area
Trial period
Flexible hours
Shift work
Day shift
Weekday work
Virtua Medical Group
Marlton, NJ
5 days ago
Remote Oncology Utilization Review Case Manager
The University of Miami is seeking a full-time Utilization Review Case Manager to work remotely. This role involves conducting chart reviews for clinical utilization and authorization to optimize patient outcomes and avoid treatment delays. The ideal candidate will hold...
Remote job
Full time
University of Miami
Miami, FL
2 days ago
Utilization Review Case Management Supervisor
$77.96k - $120.37k
...The Case Management Supervisor is responsible for directing the operations of their designated... ...limited sales management. This is a remote position. ESSENTIAL FUNCTIONS &... ...technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets...
Remote work
Minimum wage
Full time
Work at office
Local area
Flexible hours
Night shift
CorVel
Folsom, CA
2 days ago
Remote Nurse Case Manager I - Utilization & Care Coordination
...Medical Group) is seeking a Case Manager to evaluate the necessity and... .... The role offers hybrid or remote work options and an... ...Registered Nurse with acute care experience and strong organizational... ...to quality patient care and utilization review processes. #J-18808-Ljbffr...
Remote work
IMG (International Medical Group)
Indianapolis, IN
1 day ago
Care Manager I, FEPI (First Episode Psychosis Initiative)
## Care Manager I, FEPI (First Episode Psychosis Initiative)Applylocations: Nashville, TNtime type: Full timeposted on: Posted 2 Days Agojob requisition... ...social determinants of health, gaps in care, and ED/IP utilization.* Provide side by side approach to consumers in...
Temporary work
Work at office
Mental Health Cooperative
Nashville, TN
1 day ago
Remote Utilization Management Nurse: Care Coordinator
$69.8k - $96.2k
A leading health services company is looking for a Utilization Management Nurse 2 to utilize clinical skills, coordinate with providers and members... ...nursing experience, preferably in emergency or critical care settings. This position offers a competitive salary of $69,8...
Remote job
Humana
New York, NY
3 days ago
Transitions of Care RN Care Manager
...Population Health Management (PHM) department at... ...delivers innovative care models using product... ...Manager provides episodic care management for Medicare Shared Savings Program... ...affect quality and utilization. 7.Follows... ...:30am-5pm ET) Remote with ability to travel...
Remote work
Full time
Work at office
Monday to Friday
Flexible hours
Afternoon shift
Early shift
Mass General Brigham Community Physicians
Somerville, MA
3 days ago
Remote Utilization Management RN - Care Coordination Leader
$71.1k - $97.8k
A healthcare company based in Arizona seeks a Utilization Management Registered Nurse to interpret and support the coordination of medical services. Responsibilities include making benefit determinations based on clinical criteria and communicating with providers and members...
Remote job
Humana Inc
Phoenix, AZ
1 day ago
RN Case Manager
...hiring an RN Case Manager. This position exists... ...personal health care decisions; and... ...This is a primarily remote position that includes... ...patterns and episodes of care that are predictive... ...compliance with Medicare requirements and... ...3 years relevant utilization review, discharge...
Remote work
Local area
HealthPartners
Bloomington, MN
1 day ago
Community Team Care Manager (MS)
$80k - $90k
...within an integrated community care team (ICCT), functioning as... ...care needs. The Complex Care Manager (CCM) is accountable for overseeing... ...both longitudinal and episodic care needs of members across... ...wellness exams, care gap closure, utilization management & readmission...
Remote work
Work at office
Immediate start
Day shift
AbsoluteCARE Inc
United States
3 days ago
Case Management Manager - Clinical Resource / Utilization Management - CMMMC
$75 - $85 per hour
...Description Job Description Job Title: Manager, Clinical Resource/Case Management Location: Remote Type: Contract | 27 Weeks Shift... ...Department to lead Case Management, Utilization Review, and Social Work in an acute care hospital. The role oversees discharge...
Remote work
Contract work
Traineeship
Monday to Friday
Shift work
Rotating shift
Day shift
NavitasPartners
Barnstable, MA
8 days ago
Remote Clinical Utilization Specialist - Behavioral Health
...Authority is seeking a Clinical Specialist to provide utilization management services. This role involves coordinating care across various providers and facilitating... ...healthcare. The position offers flexibility with remote work possibilities under supervisory approval. #J...
Remote work
Detroit Wayne Mental Health Authority
Detroit, MI
5 days ago
TEG Clinical Specialist Remote, Drive Utilization & Growth
...Clinical Advisor/Specialist to drive the utilization of the TEG product line. This role... ...education skills and experience in critical care environments. The ideal candidate should... ...degree. Responsibilities include territory management, customer training, and ensuring...
Remote work
Haemonetics Software Solutions
Washington DC
4 days ago
Remote Clinical Utilization Specialist - Behavioral Health
$77.65k - $98.39k
...Network is seeking a Clinical Specialist for Utilization Management. This full-time position includes... ...consumers, ensuring an integrated approach to care delivery. Ideal candidates will have a... ...Currently, this position is primarily remote, with occasional site visits required....
Remote work
Full time
Detroit Wayne Integrated Health Network
Detroit, MI
23 hours ago
Utilization Care Manager
$80.33k - $160.62k
...Utilization Care Manager Reports to the Director of Care Management or designee. Conducts surveillance... ...level of care questions. Reviews all Medicare patient admissions daily and ensures... ...patient throughput during current episode of care, and to identify delays. Delivers...
Work at office
Shift work
Brown University Health
Providence, RI
1 day ago
Utility Services Care Coordinators (Energy Assistance Program)
$22 per hour
A-Line Staffing is now hiring Utility Services Care Coordinators (Energy Assistance Program) in Detroit... ...the Fisher Building in Detroit, then remote with 2 in‑office days per week... ...Ability to handle high-volume calls and manage multiple priorities. Strong attention...
Remote work
Hourly pay
Full time
Contract work
Work at office
Immediate start
Monday to Friday
2 days per week
A-Line Staffing Solutions
Detroit, MI
5 days ago
Nurse Director Utilization Review and Case Management
...your Mondays as the Nurse Director Utilization Review and Case Management at an award winning hospital in the... ...where your strategic vision transforms care coordination into measurable results... ...support, virtual nursing, and remote monitoring; clear investment in clinician...
Remote work
Weekend work
Clinical Management Consultants
Berkeley, CA
2 days ago
Clinical Specialist Utilization Management
...general supervision of the Director of Utilization Management for the Detroit Wayne Integrated... ...clinical expertise and consultation for care coordination teams. Facilitates an... ...State of Michigan. This position can work remotely with supervisory approval. Currently...
Remote work
Temporary work
Work at office
Detroit Wayne Mental Health Authority
Detroit, MI
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Episodic Care Manager Medicare Utilization. Be the first to apply!