- Centene Corporation (Newark, DE)
- …with case managers throughout the whole state of DE.** **Rotating on call** ** LTSS Team** **Position Purpose:** Supervises the care coordination team that serves ... needs and/or behavioral/mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …accountable for the daily work of employees who provide utilization management, clinical and medical necessity claim related services and support. This position ... queues and coordination of department workflow, projects, staffing, etc. The Supervisor provides Medical Services representation at various internal and external… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and ... interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to… more
- AmeriHealth Caritas (Harrisburg, PA)
- … and services.; + Maintains operational processes, policies, and procedures to support LTSS care delivery + Ensure quality and performance metrics are ... Participants.; + Serves as a subject matter expert for LTSS training for internal care teams and... teams and external audiences.; + Supports coordination of LTSS with other clinical and social services… more
- UPMC (Philadelphia, PA)
- …working from home and in office. Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports ( LTSS ) program serving seniors and ... UPMC Health Plan is looking for Service Coordinator Supervisor positions to join the Community HealthChoices team...information. + Responsible for the operational functions of the LTSS Team primarily focused on the service coordination model… more
- Fallon Health (Worcester, MA)
- …disease management staff fostering integration within care teams and member care plans * Collaboratively working with Clinical Integration Leaders to ... care needs according to product requirements working with clinical integration staff and leaders to ensure compliance and..., Group Adult Foster Care , Adult Foster Care , Long Term Care Providers, LTSS… more
- CVS Health (Springfield, IL)
- …LCSW, or LMFT, and travels up to 10 **%** of the time. The Supervisor is responsible for oversight of LTSS /Waiver healthcare case management staff including ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Commonwealth Care Alliance (Boston, MA)
- …more years of Home Health Care experience + 2 or more years of LTSS experience + 2 or more years working in a Medicare Advantage health Plan **Required ... Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making.… more
- BrightSpring Health Services (Greensboro, NC)
- …+ Develops positive relationships among and between members, family/guardians, Extenders, clinical and care team members and other community stakeholders ... events that align with minimum contact expectations to the Care Management Supervisor . + Maintains an accurate,...degree accumulated experience with the IDD population; and For care managers serving members with LTSS needs:… more
- CVS Health (Richmond, VA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Management position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of...policies and programs are comprised of network management and clinical coverage policies. Through the use of clinical… more