- Highmark Health (Jackson, MS)
- …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
- Molina Healthcare (Jackson, MS)
- …for regular outreach and management. + Promotes integration of services for members including behavioral health care and long term services and supports to ... delivery of care across the continuum, including behavioral health and long term care...Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and… more
- CVS Health (Jackson, MS)
- …Experience in evaluation of cost analysis, quality care , and health care outcomes reporting + Experience with behavioral health Institutes of Quality ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....settlement negotiations of contracts, with large and complex, national, behavioral health groups and facility providers. Role… more
- Highmark Health (Jackson, MS)
- …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
- Highmark Health (Jackson, MS)
- …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 (Jackson, MS)
- …, 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
- Molina Healthcare (Jackson, MS)
- …for regular outreach and management. + Promotes integration of services for members including behavioral health care and long term services and supports/home ... delivery of care across the continuum, including behavioral health and long term care...settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If you… more
- Highmark Health (Jackson, MS)
- …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
- Molina Healthcare (Jackson, MS)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... + 1-3 years in case management, disease management, managed care or medical or behavioral health...+ Advanced Practice Social Worker (APSW) + Certified Case Manager (CCM) + Certified in Health Education… more
- Highmark Health (Jackson, MS)
- …for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line ... + Analyze clinical data to assess potential stop loss and managed care claim liability and utilize Case Management oversight techniques to ensure front… more
- J&J Family of Companies (Jackson, MS)
- 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
- Molina Healthcare (Jackson, MS)
- …Capitated payments for Hospitals, Independent Practice Associations, and complex Behavioral Health arrangements. Maintains network adequacy, issue escalations ... of establishing a sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members, in addition to identifying… more
- Molina Healthcare (Jackson, MS)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health...Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and… more
- Sharecare (Jackson, MS)
- …coordinates with the Primary Care Provider and all other members of the health care team to support appropriate total healthcare management and ensure cost ... in the appropriate stratification level. + Identifies participant barriers to accessing health care services. Coordinates with Provider Service Managers and/or… more
- Molina Healthcare (Jackson, MS)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... focusing on seven primary areas (ToC Pillars): medication management, use of personal health record, follow up care , signs and symptoms of worsening condition,… more
- CVS Health (Jackson, MS)
- … care and behavioral health services. + Provide oversight of behavioral health care , including quality and training to new providers. **Major ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....Care providers report directly to the MinuteClinic Virtual Care Senior Practice Manager . ** **Contingent opportunity**… more
- Highmark Health (Jackson, MS)
- …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
- Community Health Systems (Jackson, MS)
- …cancer care , emergency department with FastTrack, orthopedics, inpatient adult behavioral health services, neurosurgery and general surgical services. Merit ... latitude is required. Typically reports to a supervisor or manager . **Requirements:** + Associate's degree and completion of radiologic...Us:** Merit Health Central is a 319-bed health care facility offering a wide range… more
- Highmark Health (Jackson, MS)
- …3 years of Working knowledge of medical procedures and terminology + 3 years of Health Care claims, Health Insurance and Benefit Administration **SKILLS** ... level of production each month, as determined by the manager to ensure compliance with DLP changes. This role...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Jackson, MS)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr Application… more