- Highmark Health (Salem, OR)
- …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
- Evolent (Salem, OR)
- …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
- Centene Corporation (Salem, OR)
- …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 (Salem, OR)
- …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
- CAI (Salem, OR)
- …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 (Salem, OR)
- …, 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 (Salem, OR)
- …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 (Salem, OR)
- …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 (Salem, OR)
- 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
- The Cigna Group (Salem, OR)
- …understand how to leverage digital tactics/channels to execute marketing strategy. + Health care and/or pharmacy industry experience strongly preferred. Software ... -related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k)...Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health … more
- Indian Health Service (Salem, OR)
- Summary Works as a Behavioral Care Manager . Coordinate the mental and physical health care of patients on an assigned patient caseload with the ... certification in chemical dependency. Obtain within one year certification in Integrated Behavioral Health /Primary Care Models If privileges or… more
- Sharecare (Salem, OR)
- …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
- Brookdale Senior Living (Albany, OR)
- …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
- Highmark Health (Salem, OR)
- …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 (Salem, OR)
- **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 (Salem, OR)
- **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
- Evolent (Salem, OR)
- …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
- CenterWell (Salem, OR)
- …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
- Fresenius Medical Center (Albany, OR)
- …Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality ... and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient...affect adherence to treatment. Works with patient, family and health care team to provide education tailored… more
- Evolent (Salem, OR)
- …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 ... proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be...either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal… more