Case Management Analyst 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. Program Overview: Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. This position is focused on assisting members in: Kankakee, Iroquois, Livingston, Ford, Champaign and surrounding counties. Position Summary/Mission: The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources. Fundamental Components • Evaluation of Members: Through the use of care management tools and information/data

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. Position Summary: The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the member’s improved health. The Case Manager develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Services strategies policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers Region. Qualified candidates must reside in one of the counties within Two Rivers (Union, Webster, Henderson, Daviess, Hancock, McLean, Ohio, Butler, Edmonson, Hart, Warren, Logan, Simpson, Allen, Monroe, Metcalfe, Barren). Evaluation of Members: Through the use of clinical assessment tools and evaluating information/data review, conducts a comprehensi

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. Location Bureau County or surrounding area. Program Overview Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in new markets across the country. Position Summary/Mission Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Fundamental Components & Physical Requirements Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Uses clinical 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. Requisition Job Description Program Overview: Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Position Summary The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process. The Case Management Coordinator facilitates appropriate healthcare outcomes for members by providing assistance with appointment scheduling, identifying and assisting with accessing benefits and education for members through the use of care management tools and resources Required Qualifications • Must reside in the state of Illinois •Must possess reliable transportation and be willing and able to travel up to 50-75% of the tim

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. Case Manager (RN) – Field Location: Mesquite, Balch Springs, Forney, Talty, Seagoville, Hutchins, Lancaster, Ferris, Red Oak, Cockrell Hill, Cedar Hill, Wilmer, West Dallas, Highland Park and South Dallas (Remote with local travel) Travel: Up to, 75% within territory Position Summary Nurse Case Manager (RN) for a work-from-home role that requires frequent local travel for in-home member visits and occasional visits to nursing facilities within the Dallas & Surrounding Areas in Texas In this role, you will deliver high-quality case management services through a combination of telephonic and face-to-face engagement, helping members navigate their healthcare needs and achieve improved health outcomes. Key Responsibilities Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines Coordinate and monitor ongoing care plan activities, adjusting as needed to improve outcomes Collaborate in multidisciplinary care reviews to optimize member health results Identify and escalate quality of care concerns through appropriate channels Engage members using motivational interviewing and coaching techniques to encourage healthy lifes

The Senior RMA Customer Experience Manager will work with the key customer account team leads to ensure customers have timely case updates. The position has to decide on fulfilment priority based on Service Level Agreements and track regional buffer stock. The manager needs to work with account leads to track the impact of open RMAs on customer datacenter capacity, so as to make allocation decisions. What you’ll be doing: Customer Satisfaction: Manage RMA cases and lead all aspects of replacement part fulfillment to clear the open RMA backlog per Service Level Agreements. Work with account teams to prioritize backlog in case of supply constraints. Case Management: Attend customers meeting, provide accurate and up-to-date information on case status, track of customer feedback and develop strategies to improve the overall customer experience. Metrics and Improvement: Generate case management metrics and analyze data to identify process improvement opportunities. Publish weekly status updates on open RMAs – supply commits, ready for pickup, shortage alerts. Collaboration: Work closely with quality and manufacturing teams to effectively communicate RMA updates and statuses to customer account teams. Facilitate seamless information flow between teams to provide exceptional customer support. Uptime and Buffer Stock: Track key customer installations uptime and work with planning team to maintain buffer stock near customer sites to proactively address potential supply shortages. Supply Allocation: Collaborate with production and repair factory planners to map out supply allocations for the open RMA backlog. Optimize resource allocation for timely resolution. Serve as Lead: Trainer and support for other case managers on program, process, customer interface and working internally as new programs develop for NPI and implemented into our global customer service team. What we need to see:

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications 2+ years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme

About the Team At OpenAI, our User Safety & Risk Operations (USRO) team helps protect our products and users from abuse, fraud, safety risks, and other forms of misuse. We operate at the front line of real-world safety and risk management, translating user and operational signals into timely decisions, effective interventions, and improvements to our systems. This role sits on a team focused on building operational capacity for new, ambiguous, and fast-moving areas of work. The team defines what needs to be built, creates the operating model to support it, and works with partner teams to make the work scalable and durable over time. About the Role We are seeking a Device Safety & Risk Operations Specialist to build the safety operating model for a new category of consumer hardware. This is a senior individual-contributor role for someone who can turn emerging product risks and incomplete requirements into practical workflows, controls, launch plans, and durable systems. You will define how product-safety incidents, critical escalations, regulated cases, and privacy-sensitive issues should be identified, investigated, escalated, resolved, and learned from. You will also establish operational requirements for case management, data access, decision logging, quality assurance, monitoring, and cross-functional response. You will stand up priority workflows through launch and early operations, then help transition them into durable homes across USRO and partner teams. The right person combines deep operational judgment with strong technical and hardware product fluency. They can move from executive-level risk framing to detailed workflow design, tabletop exercises, launch readiness, frontline guidance, and post-launch improvement. Location / work model: San Francisco, CA; hybrid, 3 days/week in-office. Please note: This role may involve exposure to sensitive or concerning material. Strong discretion, judgment, and resilience are essential. In This Role, You Will:

About the Team At OpenAI, our User Safety & Risk Operations (USRO) team helps protect our products and users from abuse, fraud, safety risks, and other forms of misuse. We operate at the front line of real-world safety and risk management, translating user and operational signals into timely decisions, effective interventions, and improvements to our systems. This role sits on a team focused on building operational capacity for new, ambiguous, and fast-moving areas of work. The team defines what needs to be built, creates the operating model to support it, and works with partner teams to make the work scalable and durable over time. About the Role We are seeking a Device Safety & Risk Operations Specialist to build the safety operating model for a new category of consumer hardware. This is a senior individual-contributor role for someone who can turn emerging product risks and incomplete requirements into practical workflows, controls, launch plans, and durable systems. You will define how product-safety incidents, critical escalations, regulated cases, and privacy-sensitive issues should be identified, investigated, escalated, resolved, and learned from. You will also establish operational requirements for case management, data access, decision logging, quality assurance, monitoring, and cross-functional response. You will stand up priority workflows through launch and early operations, then help transition them into durable homes across USRO and partner teams. The right person combines deep operational judgment with strong technical and hardware product fluency. They can move from executive-level risk framing to detailed workflow design, tabletop exercises, launch readiness, frontline guidance, and post-launch improvement. Location / work model: San Francisco, CA; hybrid, 3 days/week in-office. Please note: This role may involve exposure to sensitive or concerning material. Strong discretion, judgment, and resilience are essential. In This Role, You Will:

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 responsible for performing utilization management (UM) reviews and authorization activities for post-acute services, including Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH), Home Health, and other post-acute levels of care. The UM Nurse Consultant evaluates medical necessity and appropriateness of services utilizing clinical criteria, applicable policies, and regulatory requirements to support quality, cost-effective care. The UM Nurse Consultant collaborates with providers, care managers, medical directors, and interdisciplinary teams to facilitate timely care transitions, ensure member needs are met, and support organizational goals. This role requires independent clinical judgment, strong critical thinking skills, and the ability to manage multiple priorities in a fast-paced environment. Required Qualifications Active, unrestricted Registered Nurse (RN) license in the state of residence. Ability to obtain and maintain additional state licensure as required by business needs. 3+ years of clinical nursing experience. 1+ years of utilization management, case management, discharge planning, managed care, or post-acute care experience. Experience reviewing medical records and applying evidence-based

Become a part of our caring community The Transition Coordinator (Care Coach 2) evaluates member's needs and requirements. This evaluation aims to achieve and/or maintain an optimal wellness state. The Coordinator does this by guiding members/families toward resources and facilitating interaction with them. These resources are appropriate for the care and wellbeing of members. The Care Coach 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Position Responsibilities: Support the ongoing member transitions in and out of the Indiana Medicaid programs, the Contractor's enrollment, and among care settings. Complete transitions and assists with the planning and preparation for them, and the follow-up care after. Works with the Member Advocate Coordinator and other member-focused departments of the plan. This collaboration ensures continuity and coordination of care and member and provider communication through the initial transition, ongoing benefit plan, and MCE transfers. Ensure the transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information such as prevention and wellness programs(s), care management and complex case management notes. Help with transitions from the custodial setting to the home and community-based setting. We ask that you have telephonic and in-person meetings within an assigned region. The purpose of these meetings is to work with various stakeholders, including long-term care members, hospital/rehab staff discharge planners, family members/POA's, PCP's, and other healthcare professionals. The ultimate goal is to prevent custodial placements whenever possible. Assess and evaluate member's needs to establish a member specific car

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 Technical Support Specialist, you will provide front-line support for Baxter's infusion systems, software applications, and connected technologies used in healthcare environments. This is where you can make an impact by helping hospitals, clinicians, biomedical technicians, and IT teams quickly resolve technical issues involving equipment that supports patient care. In this role, you'll balance technical support activities with case management and ticket processing while partnering with customers to maintain system performance and uptime. What You'll Do Provide Level 1 technical support via phone, email, and future chat channels for Baxter infusion pumps, associated software, and connected digital products. Troubleshoot hardware, software, connectivity, and system-related issues using established troubleshooting guides, technical documentation, and standard operating procedures. Process, document, and manage customer cases, ensuring accurate updates, issue tracking, and timely resolut

The Starting Hourly Rate / Salario por Hora Inicial is $18.50 USD per hour. The Pay Range / Rango salarial is $18.50 USD - $27.75 USD per hour. ALL ABOUT TARGET As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers. Working at Target means the opportunity to help all families discover the joy of everyday life. Caring for our communities is woven into who we are, and we invest in the places we collectively live, work and play. We prioritize relationships, fuel and develop talent by creating growth opportunities, and succeed as one Target team. At our core, our purpose is ingrained in who we are, what we value, and how we work. It's how we care, grow, and win together. ALL ABOUT ASSETS PROTECTION Assets Protection (AP) teams function to keep our guests, team and brand safe and secure and lead through crisis events. They protect profitable sales by mitigating shortage risks, preventing, investigating and resolving theft and fraud to ensure product is available for our guest. At Target, we believe in our team members having meaningful experiences that help them build and develop skills for a career. The role of a Target Security Specialist can provide you with the: Skills using intelligence-led tactics to keep team members and guests safe and secure Experience in crisis response, safety and crowd management; providing support to both guests and team members Skills in de-escalation as well as experience with recovering stolen merchandise to prevent shortage Ability to utilize Target's video surveillance system Ability to properly document cases using industry case management systems As a Target Security Specialist, no two days are ever the same, but a typical day will most l

About the Team OpenAI's People team helps hire, develop, and support the people building safe and beneficial AGI. Within that team, People Systems builds the technical foundation that enables our HR, recruiting, payroll, benefits, and performance operations to scale with quality, speed, and rigor. We work at the intersection of HR systems, software engineering, and internal tooling. Our goal is not just to keep core systems running, but to build durable technical leverage for the company. About the Role We're hiring a Workday Engineer to help design, build, and operate the systems that power critical people workflows at OpenAI. This is a highly technical role for someone who combines strong Workday expertise with real engineering fluency. You'll build reliable integrations, improve system architecture, automate complex workflows, and help connect Workday to internal tools, external platforms, and emerging AI-driven systems. You should be comfortable going beyond configuration work. We're looking for someone who can reason through ambiguous systems problems, write and debug technical solutions, work effectively in Git-based environments, and use modern developer workflows, including CLI-driven tooling, to build and operate with speed and discipline. You'll partner closely with cross-functional teams across People, Finance, Security, and Engineering, including our People Innovations team, to build systems that are secure, scalable, and practical. Some work will involve improving mature production infrastructure; some will involve building entirely new workflows and capabilities from scratch. In this role, you will Design, build, and maintain Workday integrations, applications, and workflow automations across domains such as payroll, benefits, recruiting, performance, and case management Improve the reliability, quality, and scalability of People systems through strong engineering, testing, and operational practices Build technical solutions that connect Workday with i