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Job Summary:The Pharmacy Lock-In Program RN is responsible for appropriately identifying members from multiple referral points for inclusion in the Lock-In Programs.Essential Functions:
Verify... read more

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... read more

Job Summary:The School Based Health Administrator collaborates with other departments and business owners to improve quality of care to CareSource school-age members through implementation of... read more

Job Summary:Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning... read more

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... read more

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... read more

Job Summary:The Utilization Management (UM) Market Operations Manager is responsible for the operational activities of UM and Appeals for a specified line(s) of business managing the development of... read more

Job Summary:The Care Manager - NICU collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the social... read more

Job Summary:The Manager, Care Management provides operational management and oversight for providing CareSource members with the right care at the right place at the right time and assisting them... read more

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... read more