• Clinical Case Manager

    CVS Health (Charleston, WV)
    …utilization of available resources and optimal, cost-effective outcomes. + Telephonic clinical case management with Medicare population. + Uses Motivational ... 3+ years of direct clinical practice experience + An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC,… more
    CVS Health (01/10/25)
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  • Behavioral Health Case

    Elevance Health (Charleston, WV)
    **Sign-on Bonus:** $3,000 The ** Behavioral Health Case Manager II** is responsible for performing case management telephonically and/or by home visits ... within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. **Location:** The ideal candidate must reside… more
    Elevance Health (01/03/25)
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  • Field Care Manager , Behavioral

    Humana (Charleston, WV)
    …us put health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs and ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are...license with a minimum of 1 year of post-degree clinical experience in behavioral health **OR** an… more
    Humana (11/20/24)
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  • Care Manager Behavioral Health…

    Highmark Health (Charleston, WV)
    …+ 3 - 5 years of post licensure experience in a combination of Behavioral Health Clinical , Case Management and/or Condition Management + Experience ... resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors… more
    Highmark Health (12/12/24)
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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 (11/20/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Charleston, WV)
    …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
    Highmark Health (01/07/25)
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  • Medicare Medical Director

    Elevance Health (Charleston, WV)
    …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective… more
    Elevance Health (01/08/25)
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  • Associate Medical Director - Orthopedic Surgery

    Elevance Health (Charleston, WV)
    …Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee ... impact:** + Determines the medical necessity of requests using clinical criteria. + Performs physician-level case review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/17/24)
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  • Clin Ops Associate Medical Director

    Elevance Health (Charleston, WV)
    …and providers. **How you will make an impact:** + Ensures timely completion of clinical case reviews for their board-certified specialty. + Makes physician to ... Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee… more
    Elevance Health (12/10/24)
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