- 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
- 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
- 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 (Frankfort, 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
- Molina Healthcare (Lexington, 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
- 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
- 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
- HCA Healthcare (Lexington, KY)
- …care. Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** + Assesses home ... and patient/family/caregiver. + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings,… more