Medical case manager jobs in the Medical & Health category and Insurance industry

ManageAbility Inc, is growing!!!! We are a Michigan based company located in Novi, MI. We are looking to fill a couple of positions available. We are seeking an experienced, licensed RN Case Manager to handle Worker's Compensation and Auto No Fault cases in the Detroit, MI area. Knowledge of local employers, providers, WC and No Fault is helpful. Case Management certification preferred. We are als...
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Location: Irving, TX This is a non-remote position Job Summary Responsible for overseeing the Integrated Case Management staff focused on assisting Molina Healthcare members with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as appropriate including member metrics and staff productivity. Evaluates the services provided and o...
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Location: Richardson, TX Education Required: Not Indicated Experience Required: At least 3 years Position Description: *MATERNAL CHILD / OB EXPERIENCE MANDATORY* BASIC FUNCTION: Requisition #429488 This position is responsible for supervising staff involved in case management activities and support for Case Management programs, developing and implementing managed care policies and procedures relat...
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Job Description Manager, Healthcare Services II JOB SUMMARY: Manages the day to day integrated team of health plan based staff responsible for cost effective delivery of healthcare services for Molina members. Oversees staff responsible for establishing clinical, financial and educational goals for members to achieve high quality patient care and optimal outcomes. Monitors information daily as app...
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Job Description Job Summary Responsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, and evaluation of services for Molina members as they transition care and follows them for at least 30 days. Conducts an onsite hospital d...
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POSITION SUMMARY: Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal s...
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