Managed Care Coordinator I

Job OverviewWhy consider a career with BlueCross BlueShield of South Carolina? For over seventy years, we have established ourselves as a cornerstone of the health insurance landscape in South Carolina. Our strong presence in the community and our A.M. Best rating of A+ (Superior) underscores our commitment to excellence. As the largest health insurance...

Overview of the Care Coordinator RoleThe Care Coordinator role is pivotal in delivering care coordination services to individuals eligible for 1915(i) programs as outlined by the North Carolina Department of Health and Human Services. This position entails proactive engagement, comprehensive assessment, and effective care coordination to guarantee that...

Job Overview:This position involves working Monday through Friday from 8:30 AM to 5:00 PM in a remote capacity. Candidates will participate in a virtual interview process with two members of the department, followed by a week of on-site training.Preferred Qualifications:Proficient computer and typing skills are essential, as multiple software applications...

Key ResponsibilitiesConducts assessments and evaluations of medical or behavioral eligibility for benefits and clinical criteria by leveraging clinical expertise, administrative policies, and established guidelines to service requests or implement health management interventions. Employs clinical knowledge and claims analysis to assess, plan, implement,...

Overview of the Care Coordinator RoleThe Care Coordinator position is essential for delivering care coordination services to individuals qualified for 1915(i) programs as designated by the North Carolina Department of Health and Human Services. This role encompasses proactive engagement, evaluation, and management of care to guarantee that members access the...

Job Overview:This position involves working Monday through Friday from 8:30 AM to 5:00 PM in a remote capacity. Candidates will participate in a Teams interview with two members of the department, followed by a week of onsite training.Key Qualifications:Proficiency in computer usage and typing is essential, as multiple software applications are utilized in...

Empower Health. Serve with Empathy. Make an Impact.Position OverviewOversees targeted patient demographics to ensure efficient and effective healthcare delivery by adhering to Case Management standards as defined by the Case Management Society of America.Involves the coordination, facilitation, monitoring, and evaluation of interventions to achieve desired...

About the RoleWe are seeking a compassionate and skilled Registered Nurse to join our care team as a Nurse Care Coordinator. In this role, you will be responsible for evaluating patients and creating personalized care plans, while communicating effectively with patients, families, and the care team.Key ResponsibilitiesEvaluate patients and develop...

LOCATION: Remote – candidates must reside in or near Buncombe County, North Carolina. This role involves travel. GENERAL STATEMENT OF JOB: The Innovations Care Coordinator (Innovations CC) is tasked with delivering proactive interventions and orchestrating care for eligible members of Vaya Health to guarantee they receive suitable assessments and...

LOCATION: Remote – candidates must reside in or near Alamance County, North Carolina. This role involves travel. GENERAL OVERVIEW OF THE POSITION The Care Management Support Specialist, referred to as Support Specialists, will assist care managers in implementing Tailored Care Management and meeting member contact obligations. Support Specialists will...

Transforming Healthcare TogetherJob SummaryWe are seeking a highly skilled Care Management Support Specialist to join our team at Prisma Health. As a key member of our Care Coordination Department, you will play a vital role in supporting the day-to-day operations and reporting requirements of our team.Key ResponsibilitiesProvide administrative and technical...

LOCATION: Remote – must reside in or near Alamance County, North Carolina. This role is designated for individuals living in North Carolina or within 40 miles of the state border. GENERAL OVERVIEW: The Integrated Care Coordinator plays a vital role in delivering proactive support and care coordination for eligible members of Vaya Health. This position is...

Position OverviewThe role of the Case Manager is essential in ensuring the effective coordination of Community Long Term Services (CLTC) for designated participants, adhering to the guidelines set forth by SCDHHS/CLTC area offices. This position involves delivering CLTC case management services through both in-person and telephonic interactions during...

Position OverviewThe role of the Case Manager is essential in ensuring the effective coordination of Community Long Term Services (CLTC) for designated participants, adhering to the guidelines set forth by SCDHHS/CLTC area offices. This position involves delivering comprehensive case management services to CLTC participants through both in-person and...

Job OverviewAs a Case Manager at FAMILYTIES OF SC LLC, you will play a vital role in coordinating Community Long Term Services (CLTC) for assigned participants. Your responsibilities will include delivering comprehensive case management services through both in-person and telephonic interactions during initial assessments, monthly check-ins, quarterly...

Position Title: Nurse Navigator Location: Columbia, Missouri Schedule: Full-time Shift: Day Job Salary Range: $75,725 - $109,554/year, commensurate with experience Overview: The University of Missouri is seeking a dedicated Nurse Navigator to enhance the general surgery oncology team at the Ellis Fischel Cancer Center. This role is essential in fostering a...

Job Overview The Clinical Coordinator acts as a key administrative link and resource within the practice, ensuring the smooth facilitation, coordination, and management of patient care processes. This position oversees clinical personnel, manages staff assignments, maintains the vacation schedule, and supports the orientation of new team members, alongside...

Job Overview The Clinical Coordinator acts as a key administrative liaison and resource within the healthcare practice, facilitating, coordinating, and supervising the patient care process. This position is accountable for managing clinical personnel, overseeing staff assignments, maintaining the vacation schedule, orienting new employees, and providing...

Job Summary:The Case Manager is a key member of the patient care team, responsible for implementing and coordinating patient care plans to ensure safe, timely, and efficient care. This role requires strong communication and problem-solving skills, with a focus on continuous improvement and cost-effectiveness.Key Responsibilities:Develop and implement patient...

Job Overview The Clinical Coordinator acts as a key administrative link and resource within the healthcare facility, facilitating, organizing, and supervising the patient care process. This position is accountable for overseeing clinical personnel, managing staff assignments, maintaining the vacation schedule, orienting new team members, and providing...