- CVS Health (Frankfort, KY)
- …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
- Molina Healthcare (KY)
- …will be given to those applicants who have previous experience working as a case manager /discharge planner within a managed care organization (MCO) like Molina. ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's… more
- Molina Healthcare (KY)
- …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...**O** **C** **I** **A** **TI** **O** **N** **:** Certified Case Manager (CCM), **PHY** **S** **I** **C**… more
- Humana (Frankfort, KY)
- …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
- Highmark Health (Frankfort, KY)
- …+ 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
- International Rescue Committee (Louisville, KY)
- Requisition ID: req56222 Job Title: Crisis Case Manager , HSPRS Sector: Social Work Employment Category: Fixed Term Employment Type: Full-Time Compensation: USD ... resources in the community (Post Release Services). The Crisis Case Manager (Level 3) conducts Home Studies...Master's degree in social work, psychology, or other relevant behavioral science in which direct clinical experience… more
- Highmark Health (Frankfort, KY)
- …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
- CVS Health (Florence, KY)
- …care more personal, convenient and affordable. **Position Summary** The High-Fidelity Wraparound (HFW) Case Manager (CM) is a person who safeguards that the ... may impact member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - +… more
- CVS Health (Louisville, KY)
- …care more personal, convenient and affordable. **Position Summary** The High-Fidelity Wraparound (HFW) Case Manager (CM) is a person who safeguards that the ... may impact member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - *… more
- Elevance Health (Louisville, KY)
- …in the following counties: Scott, Clark, Floyd, and Harrison counties.** The **RN Case Manager ** **(LTSS Service Coordinator- RN)** is responsible for overall ... management of member's case within the scope of licensure; provides supervision and...an impact:** + Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management… more
- Elevance Health (Louisville, KY)
- …the following counties: Scott, Clark, Floyd, and Harrison counties.** The ** Case Manager - LCSW/LSW/LMSW/LMHC/LMFT** (also called the **LTSS Service Coordinator ... - Clinician)** has overall responsibility for the member's case , as required by the IN PathWays for Aging...coordination and management of member's needs, including physical health, behavioral health, social services and long term services and… more
- Elevance Health (Louisville, KY)
- …circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable state law and contract, ... + Uses tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for… more
- Molina Healthcare (KY)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... the Molina CEO + Extend scope to more fully include related areas besides 'Medical/ Clinical ', for example Behavioral Health, Long Term Care + Assist in proposing… more
- Molina Healthcare (Owensboro, KY)
- …Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan. + Schedules member visits with team ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high...+ Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify… more
- Molina Healthcare (KY)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... management, disease management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical auditing/review… more
- Highmark Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …**LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language (Other than English):** None **Travel ... **EXPERIENCE** **Required** + 5 years with Any combination of clinical , case management, and/or disease/condition management experience,...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Molina Healthcare (Lexington, KY)
- …levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member ... align with Molina auditing policy and protocols + Assists Manager with data for team member performance reviews +...clinical gaps in care from a medical and/or behavioral perspective to ensure member needs are being met.… more
- Elevance Health (Louisville, KY)
- …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
- CenterWell (Lexington, KY)
- …of care coordination efforts to other members of the team, and handle clinical escalations as indicated. This role requires an understanding of how socio-economic ... health outcomes. Experience will ideally include prior work with patients with behavioral health diagnoses, as well as in navigating local community-based resources… more