• Care Manager Behavioral

    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
    Highmark Health (12/12/24)
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  • Clinical Care Manager

    Evolent (Jackson, MS)
    …providing better health outcomes for this population. **What You'll Be Doing:** + The Behavioral Health Case Manager (LCSW or LMHC) will connect with the ... , we seek to connect the pieces of fragmented health care system and ensure people get...or Registered Nurse (RN), Required + 3-5 years of behavioral health experience, preferably in a hospital,… more
    Evolent (11/05/24)
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  • Telephonic Behavior Health Care

    Humana (Jackson, MS)
    **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2 , in a telephonic ... the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation… more
    Humana (12/19/24)
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  • Product Manager - Care Management

    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 (11/02/24)
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  • Complex Case Manager RN (Remote)

    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
    Highmark Health (11/20/24)
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  • Senior Category Manager

    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
    Highmark Health (12/12/24)
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  • Excess Risk Managed Care Clinician

    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
    Highmark Health (11/25/24)
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  • Site Activation CAR-T Senior Manager , Cell…

    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
    J&J Family of Companies (12/18/24)
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  • Manager , Provider Contracts (Remote in MS…

    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 (10/10/24)
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  • Clinical RN Comp Care - Remote

    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
    Sharecare (12/17/24)
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  • Director, Complex Care Strategy Advancement

    CenterWell (Jackson, MS)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... minimum of three years experience post Master's level training, health care actuarial experience, health ...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (12/10/24)
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  • Licensed Psychiatric & Family Nurse Practitioner…

    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
    CVS Health (12/14/24)
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  • RN Registered Nurse - AHN Home Infusion…

    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
    Highmark Health (12/06/24)
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  • CT Technologist

    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
    Community Health Systems (12/07/24)
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  • Senior Application Developer (Person360 & MDM)

    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
    Highmark Health (10/31/24)
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  • Senior Business Systems Analyst (Person360…

    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 level role… more
    Highmark Health (10/31/24)
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  • Coordinator, Utilization Management

    Evolent (Jackson, MS)
    …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,...either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal… more
    Evolent (12/24/24)
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  • LPN/LVN

    CenterWell (Jackson, MS)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (12/12/24)
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  • Physician

    CenterWell (Jackson, MS)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... health first** The Physician serves as a health - care professional and capable of handling a...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (12/20/24)
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  • Strategy Advancement Advisor, MSO Operations

    CenterWell (Jackson, MS)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (12/21/24)
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