Care Management Support Assistant in United States

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is open to candidates located in Arizona. The work schedule is Monday through Friday, from 8:30 AM to 5:00 PM Arizona time. The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. Additional responsibilities include but not limited to the following: - Evaluates patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff, and coordinate the required services by the benefit plan. - Communicates health care service delivery as required based on outcomes/reviews noted by the nurse or medical director - Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases. - Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropria

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Location: Remote (Preference for candidates in Central or Eastern Time Zones) Schedule: 24/7 operation; includes evenings, weekends, and holidays Are you an experienced Registered Nurse looking to leverage your clinical expertise in a collaborative, fast-paced environment? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, high-quality healthcare services across the continuum of care. What You'll Do Review and assess clinical information to support coverage determinations and care recommendations. Apply clinical guidelines, policies, and professional judgment to utilization management decisions. Collaborate with providers and interdisciplinary teams to coordinate care and treatment plans. Identify opportunities for care management referrals and enhanced member support services. Promote quality outcomes, effective healthcare utilization, and member-centered care. Serve as a clinical resource for internal and external stakeholders. Required Qualifications Active, unrestricted RN license in your state of residence. 2+ years of RN experience in adult acute care or critical care settings. Associate Degree in Nursing (ADN). Strong communication, critica

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary – Case Manager Analyst - Field Location: Will & DuPage Counties, IL Must reside in one of the following Zip Codes: 60606, 60607, 60608, 60609, 60610, 60611, 60612, 60614, 60622, 60623, 60624, 60632, 60639, 60644, 60647, 60651, 60653 This Case Management Analyst Field position is with Aetna’s Long-Term Services & Supports (LTSS) team and is a field-based position. The requirement is for candidates to travel up to 75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meeting contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary – Case Manager Analyst - Field Location: Champaign, IL This Case Management Analyst Field position is with Aetna’s Long-Term Services & Supports (LTSS) team. The requirement is for candidates to travel 75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in person quarterly visits with members. This position is critical to meeting contractual requirements. Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources. Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member’s needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case man

Become a part of our caring community The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. You will report to the Manager, Care Management of Behavioral Health. The Field Care Manager Nurse 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. In this role, you will travel up to 50% of the time to support collaboration, conduct face-to-face meetings, and engage directly with staff, providers, members, and their families. NOTE: You should reside close to the Midlands OR Upstate area where your region will be. Use your skills to make an impact Required Qualifications Bachelor's in nursing (BSN) and have an active license in the state of South Carolina without disciplinary action. Must reside in the State of South Carolina 2 or more years of experience of case/care management 2 or more years working with the behavioral health population Knowledge of community health and social service agencies and additional community resources Use a variety of electronic information applications/software programs including electronic medical recor

Become a part of our caring community The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. You will report to the Manager, Care Management of Behavioral Health. The Field Care Manager Nurse 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. In this role, you will travel up to 50% of the time to support collaboration, conduct face-to-face meetings, and engage directly with staff, providers, members, and their families. Note: travel requirements have shifted and you will only need to travel up to 50%. Also, one of the questions within the application relate to travel and can't be adjusted to reflect the change. NOTE: You should reside in the Midlands OR Upstate area where your region will be. Use your skills to make an impact Required Qualifications Bachelor's in nursing (BSN) and have an active license in the state of South Carolina without disciplinary action. Must reside in the State of South Carolina 2 or more years of experience of case/care management 2 or more years working with the behavioral hea

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Account Manager is responsible for managing and supporting an assigned segment of one of Aetna International's largest and most complex global client relationships. This role serves as the primary point of contact for a defined group of client stakeholders within designated geographic regions, providing strategic account management, operational support, and consultative guidance to ensure a high level of service and client satisfaction. Operating within a highly customized service environment supporting globally distributed populations, the Account Manager partners closely with client contacts, internal business partners, and external vendors to resolve complex issues, drive service improvements, and execute account strategies aligned with client objectives and organizational goals. The successful candidate will balance strategic relationship management with day-to-day operational support, while navigating complex healthcare and administrative challenges across multiple regions, cultures, and time zones. Key Responsibilities Serve as the primary account management contact for assigned client stakeholders within designated geographic regions, building trusted relationships and ensuring a high level of client satisfaction. Provide proactive account management support aligned with client objectives,

Become a part of our caring community The Medical Director, National Outpatient Medicare leverages clinical expertise and medical judgment to review preauthorization requests for services. This role is responsible for evaluating moderately complex to complex cases, where analysis of clinical information and situational factors requires in-depth assessment and sound decision-making. As a Medical Director at Humana , you will use your clinical expertise and judgment to make meaningful coverage and care determinations that support quality, consistency, and compliance across the healthcare continuum. In this role, you will review requests for services, level of care, and site of service, using nationally recognized clinical guidelines, CMS policies, medical references, and internal clinical resources to guide decision-making. This position offers the opportunity to work on complex outpatient cases , review clinical documentation, and collaborate with both internal partners and external physicians to gather additional information and discuss determinations. You may also contribute to care management activities and, depending on the role, provide input on areas such as clinical documentation, coding, grievances and appeals, and outpatient services or equipment reviews. Beyond case review, this role provides the opportunity to build strong relationships with physicians, provider groups, facilities, and community partners in support of regional priorities. It is a strong fit for physicians who are interested in contributing to value-based care, population health, and care management strategies while working in a structured environment that values sound clinical judgment, collaboration, and operational excellence. Humana is seeking a Medical Director to

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. *Open to fully remote anywhere in the U.S. or hybrid work location for this role* Position Summary The Senior Analyst, Account Management is responsible for the day-to-day management and support of Meritain's Alternative Health & Advocacy Solutions partner portfolio, including navigation, advocacy, and point solution vendors. This role serves as a primary operational contact for assigned partners and internal stakeholders, driving service excellence, issue resolution, partner accountability, and ongoing relationship management. The individual will partner closely with Account Executives, sales leadership, client management teams, implementation teams, and operational stakeholders to support partner performance, facilitate cross-functional collaboration, and execute strategic initiatives that improve client, member, and partner experience. Responsibilities include monitoring operational performance, coordinating issue remediation, supporting implementations and escalations, maintaining governance processes, identifying opportunities for improvement, and contributing to sales enablement and growth initiatives. The ideal candidate demonstrates strong relationship management skills, operational acumen, project coordination capabilities, and the ability to navigate complex stakeholder environments while supporting innovative healthcare solutions. Required Q

Job Title Disease management Solutions Clinical Support Specialist (90% Travel M-F) Job Description Disease management Solutions Clinical Support Specialist (90% Travel M-F) Help healthcare providers maximize the value of Philips Disease Management Solutions by delivering expert clinical training, product education, and implementation support across a highly customer-facing field role. Your role: Deliver hands-on and remote clinical training for Philips Disease Management Solutions products, with primary focus on DynaCAD and UroNav, ensuring customer competency and successful adoption. Serve as a trusted clinical consultant to physicians and technologists, providing education, workflow guidance, and application support that improves customer productivity and outcomes. Partner closely with Sales, Marketing, Service, Customer Support, Quality, Research & Development, and Manufacturing teams to support customer success, product implementations, and new product introductions. Demonstrate product expertise, you will be responsible for product assembly and installation for the UroNAV product as well as troubleshoot software and workflow issues, and help customers optimize their use of advanced imaging and post-processing solutions. Travel extensively (approximately 90%) to customer sites throughout the U.S., working from a home-based office and supporting changing customer locations as business needs require. You're the right fit if: You’ve acquired 5+ years of clinical experience as an MRI Technologist and/or Ultrasound Technologist, with strong knowledge of imaging workflows and patient care environments. Your skills include troubleshooting software, computer, networking, and basic Digital Imaging and Communications in Medicine (DICOM) issues, along with strong teaching, presentation, a

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Your Role at Baxter As a Sales Support Specialist, you will support daily customer and sales operations for Baxter's cardiac monitoring business. You will manage orders, maintain customer accounts, support lead management activities, coordinate with third-party partners, and help resolve customer inquiries. Success in this role is measured by accuracy, responsiveness, customer satisfaction, and operational efficiency. Your Team You will be part of the Customer Operations and Sales Support team, partnering closely with Sales, Customer Service, Operations, Logistics, and external vendors to deliver a best-in-class customer experience. The team is focused on service excellence, continuous improvement, and supporting customers with the tools and solutions they need to improve patient care. What You'll Be Doing Process, review, and track customer and sales orders in accordance with established procedures and quality standards. Respond to customer, patient, and sales inquiries related to orders,

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team and play a vital role in ensuring members receive appropriate, high-quality, and cost-effective inpatient care through concurrent review and care coordination. What You'll Do Perform concurrent reviews for acute inpatient admissions and continued hospital stays Evaluate medical necessity, severity of illness, intensity of service, and level of care using evidence-based clinical criteria Collaborate with hospitals, physicians, care managers, and discharge planners to support appropriate treatment and timely transitions of care Review clinical documentation and apply health plan benefits and regulatory requirements to authorization decisions Partner with Medical Directors on complex cases and escalations Facilitate discharge planning and identify opportunities to optimize care and resource utilization Manage a high-volume caseload while meeting quality, productivity, and turnaround-time standards WHAT YOU BRING - REQUIRED Active, unrestricted RN license in your state of residence Ability to obtain and maintain additional state licensure as required 5&#43

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Manager, Care Program Strategy & Operations (Vaccine) Location: Remote/Virtual Role Description: The Manager, Care Program Strategy & Operations (Vaccine) plays a critical role within Oak Street Health’s Population Health organization, supporting the design, implementation, and scaling of programs that improve patient health outcomes and advance value-based care objectives. This role focuses on vaccine strategy and execution, driving initiatives that improve immunization rates, close care gaps, and support preventative care delivery across the organization. Serving as a key cross-functional leader, this individual partners closely with Population Health, Clinical Operations, Nursing, Providers, Patient Safety, Epic, and external healthcare partners to develop and implement innovative solutions that improve patient outcomes and operational performance. The role requires strong project management capabilities, stakeholder influence, and the ability to execute complex initiatives across multiple teams and partners. This is a highly visible role responsible for bringing new ideas from concept to execution, including the development of pilot programs, evaluation of results, and scaling of successful interventions across Oak Street Health centers nationwide. The Manager will also support strategic partnerships an

Work Flexibility: Field-based Emergency Care (Fire/EMS) Sales Representative As a Sales Representative at Stryker, you will be at the forefront of promoting and selling our Emergency Care products, with a focus on Fire Emergency Medical Services solutions, to pre-hospital providers. You’ll work with a diverse range of products, including Emergency Patient Transport, Defibrillators, Automated External Defibrillators (AED), and Chest Compression systems. This role will involve building and maintaining strong customer relationships, addressing inquiries, negotiating pricing, and managing orders seamlessly. By staying informed on industry trends, competitor activity, and regulatory shifts, you’ll position Stryker’s products effectively in the marketplace. You’ll also have the opportunity to exceed sales targets, monitor your performance, and collaborate with marketing and support teams to drive business growth and success. What you will do Continue experience in sales or clinical setting. Promote and sell Stryker Emergency Care products to meet our customers’ needs. Achieve your assigned quota by taking a consultative approach to Pre-Hospital sales, marketing, clinical and demonstrations of all related Fire/Emergency Medical Services products and programs. Become the resident Emergency Care expert as you work with a sophisticated audience of fire chiefs, medical directors, clinical instructors and administrators. Your knowledge not only of your own products, but of competitors’ offerings, builds credibility with your customers. <span style="f

Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations. You will report to the Manager of Utilization Management and serve as a member of the One Home/Home Solutions Utilization Management team. This team manages post-acute care services. These services include Skilled Nursing Facility (SNF), Home Health, and Durable Medical Equipment (DME). The team's goal is to ensure members receive the appropriate level of care in the most appropriate setting. As a Utilization Management Registered Nurse: You will use clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration determinations. Using established medical criteria, you will make determinations based on information provided by the attending physician and other care providers You will complete request determinations within established processing time frames. (i.e. 10 reviews per day?) You will communicate with providers, members, or other parties to facilitate care and treatment. You will help deliver coordinated care for our members You will understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Use your skills to make an impact Required Qualifications: Must hold Compact Registered Nurse (RN) license in your state of residence Greater than one year of clinical experience as a RN in a hospital, SNF, Home Health, or acute care setting. Must be passionate about contributing to an organization focused on improving consumer experiences Preferr