- HCR Home Care (Canton, NY)
- …using the development of person-centered goals, culturally competent care management , and professional healthcare and social service coordination. Health Home ... manage, and integrate solutions and resources for all primary, complex chronic diseases, behavioral health and long-term care needs in the Health Home Program. This… more
- HCA Healthcare (Nashville, TN)
- …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- CenterWell (Tampa, FL)
- …of our caring community and help us put health first** The Manager Care/Case Management in **Tampa area (** **_this is not a remote position_** **)** is responsible ... for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high needs patients using a team-based approach to… more
- Commonwealth Care Alliance (Springfield, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... & Language (nice to have):** + Familiarity with care management and utilization management systems... systems and workflows for populations with complex medical, behavioral health, and/or social needs. + Strong understanding of… more
- Elevance Health (NC)
- …overall healthcare costs for the designated population via integrated (physical health/ behavioral health) case management and whole person health. Manages ... the same basic benefits and services, including Physical health, Behavioral health, Pharmacy, Intellectual/Developmental Disabilities (I/DD) services, long term… more
- US Tech Solutions (Columbia, SC)
- …A typical day would like in this role: Employee will be providing telephonic case management and utilization management for our members. The expectation is ... **Job Description:** + Must be an RN in SC and have an active and...+ Strong communication skills required to provide telephonic case management to patients and to coordinate with team, providers,… more
- Commonwealth Care Alliance (Boston, MA)
- …Community Health Workers (CHWs) are key supports to interdisciplinary care management teams and complement and support enrollees' needs, goals, and preferences. ... coaching skills to improve CCA enrollee outcomes by impacting care access and utilization , closing care quality gaps, and optimizing member connection to medical, … more
- Beth Israel Lahey Health (Peabody, MA)
- …to the age of the patient Cares for patients as delegated by the provider, RN or LPN within scope of practice and competence. Contributes information provided by the ... registry health data for identified patient populations Monitors patient progress by utilization of disease specific registries to proactively reach out to patients… more
- Molina Healthcare (Bowling Green, KY)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... the state health plan's Healthcare Services (clinical operations) teams including Utilization Management (prior-authorization, inpatient review) and Care … more
- Elevance Health (Atlanta, GA)
- …and experience which would provide an equivalent background. Previous experience in case management / utilization management with a broad range of experience ... member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance...unrestricted license in the state of Georgia such as RN LCSW LPC (as allowed by applicable state laws)… more