- Humana (Charleston, WV)
- …resources, schedules and goals. The Manager , Utilization Management Behavioral Health uses clinical knowledge, communication skills, and independent ... coaching, performance review, up to termination. + Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work… more
- CAI (Charleston, WV)
- …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! If you ... apply now. **Job Description** We are looking for a Case Manager , RN to provide community-based care...referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management +… more
- Highmark Health (Charleston, WV)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- Highmark Health (Charleston, WV)
- …services. Advocates for the most appropriate care plan using sound clinical judgment; accurate planning, and collaboration with internal and/or external customers ... with external contacts. + Communicate effectively while interacting with Case Management Specialists, Management Team, Physician Advisors and other interdepartmental… more
- Intermountain Health (Charleston, WV)
- …and provides short term treatment planning for mental, emotional and behavioral disorders, conditions and addictions. **Essentials:** + Participates in case ... psychosocial functioning for the purpose of diagnosing mental, emotional, behavioral , addictive and developmental disorders and disabilities, implementing appropriate… more
- Highmark Health (Charleston, WV)
- …Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify ... related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more