- Highmark Health (Dover, DE)
- …the effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in… more
- Highmark Health (Dover, DE)
- …implement and evaluate care for eligible members with chronic and complex health care , social service and custodial needs in a nursing facility or ... address the member's specific needs. + Educate members or caregivers regarding health care needs, available benefits, resources and services including available… more
- Highmark Health (Dover, DE)
- …implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. + Function in… more
- Centene Corporation (Newark, DE)
- …facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare ... plan/service plan for the best outcome, which may include behavioral health and social determinant needs +...to identify providers, specialists, and community resources needed for care including mental health and substance use… more
- Highmark Health (Dover, DE)
- …Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Highmark Health (Dover, DE)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- Highmark Health (Dover, DE)
- …complex medical and/or psychosocial needs have access to high quality, cost-effective health care . Assists in the holistic assessment, planning, arranging, ... understanding of illness/disease impact and to positively impact member care plan adherence, pharmacy regimen maintenance, and health...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Dover, DE)
- …in a project manager role **Preferred** + Leadership experience + Health Care Insurance industry business and operational knowledge + Experience managing ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Dover, DE)
- …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
- AmeriHealth Caritas (Dover, DE)
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care ... , stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives… more
- AmeriHealth Caritas (Wilmington, DE)
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care ... , stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of… more
- J&J Family of Companies (Dover, DE)
- Johnson & Johnson is recruiting for a field-based Site Activation CAR-T Senior Manager , Cell Therapy Experience Lead to support the United States. This is a field ... close proximity to a major metropolitan airport. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a… more
- Magellan Health Services (Dover AFB, DE)
- …DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt License and Certifications - Preferred ... child development centers, and consultation to installation command regarding behavioral health issues affecting children and youth....by the Office of Secretary of Defense (OSD) program manager . The CYB will flex schedule to respond to… more
- Sunrise Senior Living (Wilmington, DE)
- …the evolving information on Alzheimer's disease. Responsible for championing the designated care manager concept throughout the neighborhood, assisting in the ... the reminiscence neighborhood. Responsibilities include promoting excellence in resident care in accordance with each resident's Individualized Service Plan… more
- Brookdale Senior Living (Dover, DE)
- …through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and ... that meet specific needs of each and all residents within the dementia care community. Provides person centered programs while engaging residents in meaningful and… more
- Elevance Health (Wilmington, DE)
- …The **Medicare Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes. +...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- CenterWell (Dover, DE)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... such as CPA, CIA + Previous experience in home health , care delivery, or care ...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Veterans Affairs, Veterans Health Administration (Dover, DE)
- …Team (PACT) Licensed Practical Nurse (LPN) GS-6 functions as a member of the health care team by demonstrating an exceptional degree of practical nursing ... clinic/PC for a Veteran population with a variety of health care needs Responsibilities LPN provides nursing...and/or changes in patients' condition and notifies the RN Care Manager (RNCM); promptly seeks the assistance… more
- Highmark Health (Dover, DE)
- …in special committee meetings as required. + Cooperates with other health care team members and the Operations Manager pursuant to the Allegheny ... timely manner. + Patients are appropriately referred to other health care support systems or community resources...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Wilmington, DE)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... Candidates must reside within 50 miles of an Elevance Health Pulse Point location. **Work schedule:** Monday - Friday...depression, and insightful analytics to improve the delivery of care . The **Clinical Ops Associate Medical Director - Ortho**… more