- Highmark Health (Charleston, WV)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN state licensure… more
- Sharecare (Charleston, WV)
- … more accessible and affordable for everyone. To learn more, visit www.Sharecare.com. The Care Manager supports the implementation of the Value Based Care ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary… more
- CVS Health (Charleston, WV)
- …. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... position consists of working intensely as a telephonic case manager with patients and their care team...setting. + A Registered Nurse that holds an active, unrestricted… more
- Intermountain Health (Charleston, WV)
- …measures. **Job Essentials** + Work collaboratively with Select Health's HEDIS Manager , Quality Consultants, and Data Analyst + Responsible for performing accurate ... software on an assigned laptop + Reviewer will perform remote or offsite medical record reviews with charts collected...when and where the member received are and verify care was received. + Reviewer must pass a medical… more
- Highmark Health (Charleston, WV)
- …in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to ... coordinate care , and identifying various resources to assist members in...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
- BrightSpring Health Services (Dunbar, WV)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... responsibility. Responsible to supervise all nursing personnel, and ensure care and services are coordinated with behavioral and programmatic...performance reviews* Responsible to ensure that there is a nurse on call after hours for all homes (and… more
- Sharecare (Charleston, WV)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... support in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to… more
- Highmark Health (Charleston, WV)
- …established industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create ... in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to… more
- Humana (Charleston, WV)
- …**Required Qualifications** + Bachelor's degree in Nurse (BSN). + Valid and unrestricted Registered Nurse ( RN ) license in the (appropriate state) with no ... desired clinical outcomes and to enhance quality of medical care . The **Telephonic Nurse Case Manager...- 5:00 pm Eastern Standard Time. **Work Style** : Remote **Work at Home/ Remote Requirements** To ensure… more
- Highmark Health (Charleston, WV)
- …+ 5 - 7 years in Social Work **LICENSES OR CERTIFICATIONS** **Required** + Registered Nurse or + Licensed Clinical Social Worker (LCSW) - Non-Specific ... Develops educational interventions to maintain contractually mandated standards of care as it applies to existing and future Policies,...**Preferred** + ACM Certification (Accredited Case Manager ) **SKILLS** + Adult Learning: Theory and Practice +… more
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