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CVS Health
Overview
The Case Manager applies a collaborative, member-centered approach to assessment, care planning, coordination, evaluation, and advocacy to address the comprehensive health needs of individuals and families. Responsibilities include serving as a liaison, implementing case management activities for complex members, and conducting outreach to treating physicians to support appropriate care planning.
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Compensation
$60,522 - $129,615 / YEAR
Posted
1 month ago
UnityPoint Health
The specialist is responsible for obtaining timely prior authorizations for medications and injections to ensure uninterrupted patient care. This includes reviewing clinical documentation, managing appeals, and collaborating with providers and insurance companies.
Salary not listed
AMERICAN ADVANCED MANAGEMENT
The role manages the administrative process of credentialing healthcare providers with insurance companies and government payers by preparing and submitting applications and tracking their status. Key duties include maintaining accurate provider records, ensuring regulatory compliance, and following up with providers and payers to resolve enrollment issues.
The Administrative Assistant oversees centralized email communications and supports credentialing operations across multiple healthcare facilities, ensuring timely responses and efficient follow-up on outstanding matters. This role coordinates facility credentialing to maintain compliance with payer, state, and federal requirements across various locations.
Hennepin Healthcare
The Utilization Review Registered Nurse evaluates the medical necessity and appropriateness of healthcare services by reviewing patient records against established criteria. This role collaborates with clinical teams and payers to optimize resource utilization and ensure quality care progression.
2 months ago
PACS
The Physical Therapist evaluates and treats residents by developing and implementing individualized treatment plans in a skilled nursing facility. They also collaborate with interdisciplinary teams and provide clinical leadership to ensure optimal resident outcomes.
$60 - $65 / HOUR
Ascension Recovery Services
The Clinical Therapist is responsible for delivering individual, group, and family therapy services, conducting assessments, and developing treatment plans. They also coordinate care and ensure compliance with documentation standards.
Lincare
The Upfront Review Clerk is responsible for the quality review of all customer information to ensure accuracy and completeness, meeting payer requirements for timely and maximum reimbursement. This includes evaluating documents for successful Accounts Receivable processing and maintaining Held Sales by assisting customer service representatives with corrections.
Golden State Orthopedics and Spine
Assist healthcare providers in applying casts, splints, and fitting patients with durable medical equipment. Handle administrative duties including patient scheduling, insurance documentation, and follow-up calls across multiple clinic locations.
$21 - $23 / HOUR
Samaritan
The specialist coordinates and secures prior authorizations for hospital and clinic services, manages outgoing referrals, and ensures compliance with payer requirements to support patient care and reimbursement. This role acts as a liaison between providers, patients, payers, and internal departments to minimize care delays and documentation errors.
$44,179 - $59,987 / YEAR
The specialist coordinates and secures prior authorizations for hospital and clinic services, manages outgoing referrals, and ensures compliance with payer requirements to support patient care and reimbursement. This role acts as a liaison between providers, patients, payers, and internal departments to minimize denials and care delays.
Gentiva
The Clinical Liaison ensures efficient intake and referral processes for hospice services by assessing patient eligibility, educating families, and coordinating admissions according to all requirements. This role involves serving as a liaison between referral sources and the care team while building professional relationships through daily visits to healthcare facilities.
UnitedHealth Group
The Licensed Practical Nurse will provide direct nursing care as prescribed by the physician to acutely ill and/or chronically ill patients in their homes, recording clinical and progress notes. Responsibilities also include coordinating other patient care activities and services to ensure the highest quality of care within the assigned geographic service area.
$20 - $36 / HOUR
NeurAbilities
The specialist conducts timely and accurate initial assessments, administers standardized autism screening tools under supervision, and develops clinically sound treatment plans to accelerate access to ABA services. This role also supports report review, clinical quality assurance, and provides short-term clinical coverage to ensure service continuity.
Lifepoint Health
The Occupational Therapist will develop specialized treatment plans to help patients regain well-being through exercise and the use of prosthetic and orthotic devices, playing an important role in their recovery. Responsibilities also include communicating patient progress to supervisors and team members, instructing family or nursing staff on follow-through programs, and documenting patient care according to regulatory requirements.
$45 - $50 / HOUR
The Registered Nurse will provide and direct nursing care to patients in their homes according to physician prescriptions and agency policies, while coordinating the total plan of care with other healthcare professionals. Primary duties include providing high-quality clinical services, completing required nursing assessments, and developing individualized plans of care from admission to discharge.
$29 - $52 / HOUR
The Occupational Therapist will develop specialized treatment plans utilizing exercise and/or prosthetic/orthotic devices to help patients regain well-being, while also communicating patient progress to supervisors and team members. Responsibilities also include instructing family or nursing staff in follow-through programs and maintaining equipment and work areas.
$45 - $55 / HOUR
Urology Centers of Alabama
The Prior Authorization Specialist coordinates and secures necessary insurance authorizations for medications, injections, and imaging to ensure timely patient care. This involves reviewing payer requirements, gathering clinical documentation, and communicating with various stakeholders to facilitate approval.
Northwest Orthopaedic Specialists
The Credentialing Specialist is responsible for managing the credentialing, re-credentialing, and privileging processes for all medical providers and maintaining accurate data in databases and online systems. This includes ensuring timely renewals of licenses and certifications for providers and practice locations.
$21 - $37 / HOUR
Surgery Partners, Inc
The coordinator manages complex patient cases by tracking multiple clearances, coordinating with vendors, and ensuring all insurance approvals are obtained prior to procedures. This role serves as a central communication point to monitor case readiness and resolve any scheduling barriers to prevent delays.
3 months ago
