• LTSS Provider Education & Outreach…

    Humana (Indianapolis, IN)
    LTSS Provider Education & Outreach Representative serves as the primary relationship manager with LTSS and HCBS providers to ensure positive provider ... us put health first** Humana Healthy Horizons in Indiana is seeking a LTSS Provider Education & Outreach Representative (Provider Engagement Professional 2) who is… more
    Humana (11/09/24)
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  • Field Case Manager , Ltss - LVN…

    Molina Healthcare (Harlingen, TX)
    …Worker residing in Harlingen, TX area to join our LTSS Team as a Case Manager working with our Medicaid members. Part of the responsibilities of the role is ... Preference will be given to those candidates with previous LTSS experience. Mileage is reimbursed as part of our...Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master's degree in a social… more
    Molina Healthcare (11/17/24)
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  • Manager Clinical Health Services…

    CVS Health (Richmond, VA)
    …required meetings and trainings (up to 20% travel estimated) **Preferred Qualifications** + Medicaid experience - LTSS experience highly preferred + Knowledge of ... make health care more personal, convenient and affordable. The Manager Clinical Health Services is a key member of...and MS Office Suite applications + Experience with DMAS Medicaid Enterprise System (MES) + Must be willing to… more
    CVS Health (11/27/24)
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  • LTSS Service Coordinator - RN

    Elevance Health (Corpus Christi, TX)
    …non-RN clinicians participating in the member's case, as required by the Texas Medicaid STAR+ PLUS program ; develops, monitors, evaluates, and revises the ... spend 3-5 days per week in-person with patients, members or providers The ** LTSS Service Coordinator- RN** is responsible for overall management of member's case… more
    Elevance Health (11/05/24)
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  • Program Manager - Clinical…

    Molina Healthcare (GA)
    **_JOB TITLE: Program Manager : HCS, Clinical Program Design, REGISTERED NURSE_** **Job Summary** Molina Healthcare Services (HCS) works with members, ... limited to Duals, LTSS and non-LTSS_ + _Clinical model design for Medicaid , Medicare and Marketplace lines of business._ + _5+ years of clinical nursing… more
    Molina Healthcare (11/14/24)
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  • Public Health Nurse III

    Fairfax County Sheriff's Office (Fairfax, VA)
    …the agency's mission and addressing client and community concerns. Coverage for the assistant program manager may also be required, along with other duties that ... approach. Also aids in interpreting and drafting local policies related to LTSS assessments. Entails guiding staff on policy and best practices in case… more
    Fairfax County Sheriff's Office (11/26/24)
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  • Salem Program Manager

    NorthWest Senior & Disability Services (Salem, OR)
    …Manage Programs + Oversee the initial and ongoing eligibility determination and case management of Medicaid LTSS program , OPI Program , and other Older ... staff who administer programs such as Medicare Savings Programs, Medicaid , Supplemental Nutrition Assistance Program (SNAP) food...and Supports to seniors and adults with disabilities. The Program Manager is responsible for their team's… more
    NorthWest Senior & Disability Services (11/22/24)
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  • Field Service Coordinator

    Humana (Linton, IN)
    …include: + Administer initial and ongoing long-term services and support ( LTSS ) related assessments through person-centered thinking approaches. + Contacts members ... goals and priorities, evaluate resources, develop plan of care and identify LTSS providers and community partnerships to provide a combination of services and… more
    Humana (10/29/24)
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  • Social Work Case Manager Sr

    Elevance Health (Woodbridge, NJ)
    …provided to NJ Medicaid members. This associate will work with the LTSS (Long-Term Services and Support) Housing Specialist to ensure that we have the structure ... The Social Work Case Manager Sr will be dedicated to the NJ...in the Healthy Homes. Wellpoint NJ will be placing Medicaid members in Healthy Homes program units… more
    Elevance Health (09/17/24)
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  • Network Relations

    CVS Health (Harrisburg, PA)
    …of Aetna policies and procedures, explain Aetna systems, etc. + Serves as primary relationship manager with LTSS and HCBS providers and/or PH and BH providers to ... relationships by assisting with or responding to complex issues regarding Medicaid policies and procedures, service, claims or compensation issues, and provider… more
    CVS Health (11/06/24)
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  • Clinical Evaluation Manager , Transition…

    VNS Health (Manhattan, NY)
    LTSS eligible population. preferred Knowledge of Medicare and Medicaid regulations required Excellent organizational and time management skills, interpersonal ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
    VNS Health (11/13/24)
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  • Case Manager RN Field - Union County NJ…

    CVS Health (Springfield, NJ)
    …in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Care manager may also be responsible for face to ... on bonus upon hire.** This is a remote Case Manager opportunity with 50 to 75% field travel in...personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment. Successful completion… more
    CVS Health (11/07/24)
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  • Clinical Evaluation Manager (RN) -- Select…

    VNS Health (Manhattan, NY)
    …cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in ... management. Maintains written progress notes and verbal communications according to program guidelines. + Participates in approval for out-of-network services when… more
    VNS Health (11/25/24)
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  • Clinical Evaluation Manager * MA Care…

    VNS Health (Manhattan, NY)
    LTSS eligible population. preferred Knowledge of Medicare and Medicaid regulations required Excellent organizational and time management skills, interpersonal ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
    VNS Health (11/22/24)
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  • Provider Engagement Professional

    Humana (Tallahassee, FL)
    …policies and procedures, explain Humana systems, etc. + Serves as primary relationship manager with LTSS , Skilled Nursing Facilities, HCBS providers and/or PH ... in Florida is seeking a Provider Engagement Professional to join the Florida Medicaid Market Team. In this role, you will develop and grow positive, long-term… more
    Humana (10/29/24)
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  • Case Manager RN - Field

    CVS Health (Brooklyn, NY)
    …candidates may be eligible for up to a $7,500 sign on bonus upon hire.** ** Program Overview** Help us elevate our patient care to a whole new level! Join our ... on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex...Previous experience with insurance + UAS-NY certification preferred + LTSS experience preferred + Confidence working at home/independent thinker,… more
    CVS Health (11/13/24)
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  • Sufficiency Supports Coordinator

    Compass Maryland (Beltsville, MD)
    …(80%): + Provide Housing Support Services (HSS) to a caseload of approximately 40 program participants, as defined in the Maryland Medicaid Waiver. + Maintain ... position's primary role is to support a caseload of program participants with housing initiatives for people to live...own homes. This position reports to the Sufficiency Support Manager . Essential functions include : + Housing Support Services… more
    Compass Maryland (11/07/24)
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