- Centene Corporation (Raleigh, NC)
- …areas** **Position Purpose:** Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare ... member needs are met + Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current… more
- CVS Health (Harrisburg, PA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... build, and load contracts, agreements, amendments, and/or fee schedules in contract management systems. Conduct research, analysis, and audits to identify issues and… more
- Elevance Health (Knoxville, TN)
- …will make an impact:** + Monitors related legislation and advises senior management relative to compliance. + Researches new ventures and prospective revenue ... Capabilities, and Experiences:** + MBA preferred. + Experience in administering long-term care programs and services strongly preferred. + CHOICES and ECF LTSS… more
- AmeriHealth Caritas (Newark, DE)
- …care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Case Manager assists members who are eligible for LTSS in… more
- Molina Healthcare (GA)
- …of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care ... care management , utilization management , behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs.… more
- Highmark Health (Dover, DE)
- …includes ensuring appropriate care transitions between home, community, and community-based care settings. + Authorize LTSS services based upon completion of ... Condition Management , Behavioral Health, and Complex Case Management . + Collaborate with the member's health care...**Preferred** + One year in home clinical or case management experience + Certified Case Manager (CCM)… more
- Elevance Health (Sylva, NC)
- …not be considered for employment, unless an accommodation is granted as required by law._ The Manager Care Management ( Manager I GBD Special Programs) is ... services, long term services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina where all children… more
- Humana (Lansing, MI)
- …and goals. + Oversee the External Oversight Team (Quality Assurance professionals and Care Management Support Assistants) staff and monitors compliance with Home ... help us put health first** Humana is seeking a Manager , Quality Assurance (External LTSS Oversight Team...to be screened for TB. **Preferred Qualifications** + Certified Care Manager (CCM). + Three (3) or… more
- BrightSpring Health Services (Roanoke Rapids, NC)
- …with LTSS needs: two years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management experience, in addition to the ... community resources to meet the needs of individuals receiving care management services. Provide services in accordance...specified below. + Two years of experience as a Care Manager , Case Manager , or… more
- MVP Health Care (Schenectady, NY)
- …the essentials of an integrated utilization management and case management model that includes assessment, planning, implementation, care coordination, ... functional capability through the coordination of quality cost effective care . + The Case Manager will also...retrospective reviews to determine medical necessity and appropriateness of LTSS services. + Care Coordination: Collaborate with… more