• Manager , Utilization Management…

    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
    Humana (03/12/25)
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  • Case Manager , RN

    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
    CAI (02/01/25)
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  • Complex Case Manager RN (Remote)

    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 (03/13/25)
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  • Medical Case Manager (West Virginia)

    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
    Highmark Health (03/19/25)
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  • Social Work Care Manager

    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
    Intermountain Health (03/15/25)
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  • Psychologist

    Holzer Health System (Gallipolis, OH)
    The Clinical psychologist reports directly to the clinical manager of the behavioral health department. The Clinical psychologist works with members ... treatment. This is achieved through assessment, treatment, individual therapy, case management, and related documentation. Education, Work Experience and Licensure:… more
    Holzer Health System (03/22/25)
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  • Coding Auditor Educator

    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
    Highmark Health (02/07/25)
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