- CVS Health (Harrisburg, PA)
- …Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations ... hours, 8:00am to 5:00pm. No weekends and no holidays. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical… more
- Highmark Health (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …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
- AmeriHealth Caritas (Harrisburg, PA)
- …care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about ... us at www.amerihealthcaritas.com.; **Responsibilities:;** ;The Community Care Manager is responsible for engaging the member and the member's caregiver and providers… more
- Highmark Health (Harrisburg, PA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- CenterWell (Harrisburg, PA)
- …Establish collaborative relationships and work with strategic key stakeholders, including clinical teams, technology and data analytics leaders, and care integration ... experience of management experience preferred in VBC/experience working within case management programs. **Preferred Qualifications** + Master's degree in health… more
- WellSpan Health (Gettysburg, PA)
- …by 2,300+ employed physicians and advanced practice providers, a regional behavioral health organization, a home care organization, eight respected hospitals, ... medicine physicians + Excellent support from an experienced Senior Practice Manager Our Commitment to You: + Physician-designed compensation model + Competitive… more
- Elevance Health (Harrisburg, PA)
- …Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee ... health and general well-being. + Collaborates with social worker and/or care manager to develop action plan. + Develops trusting relationship with employees by… more
- Highmark Health (Harrisburg, PA)
- …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