- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
- Molina Healthcare (Madison, WI)
- …DESCRIPTION** Program Manager for Healthcare Services available for either RN or a Behavioral Health Specialist who has a license in good standing in their ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** The Molina Population Health Management Case Manager uses clinical judgment, knowledge, and direct hands-on member care ... health settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Certified Case Manager (CCM) Certified Diabetes Educator To all current Molina… more
- Molina Healthcare (Baraboo, WI)
- …concerns. + Collaborates with RN case managers/supervisors as needed or required + Case managers in Behavioral Health and Social Science fields may ... an integrated delivery of care across the continuum, including behavioral health and long term care, for...Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health… more
- Meriter-UnityPoint Health (Madison, WI)
- …backgrounds and their effected family members. This position is the primary case manager for patients receiving Addiction Medicine services. When applicable, ... professional development. EEO/M/F/D/V Auto req ID:13113BRWeekends:NoZip Code:53719Compensation:Commensurate with experience.Job Title:Addictions/ Behavioral Health IOP Therapist; New Start 1.0FTE;… more
- Highmark Health (Madison, WI)
- …ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...various resources to assist members in achieving their personal health goals. The incumbent monitors, improves and maintains quality… more
- CAI (Madison, WI)
- …including facilitating referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health , and Complex Case Management + ... Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us...Care Plans + Experience collaborating with PCP's, Occupational Therapists, Behavioral Health , and Providers + Experience with… more
- Molina Healthcare (Madison, WI)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... and suggest changes accordingly. + Promotes integration of services for members including behavioral health care and long term services and supports, home and… more
- Molina Healthcare (Dane, WI)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... and suggest changes accordingly. + Promotes integration of services for members including behavioral health care and long-term services and supports, home and… more
- Highmark Health (Madison, WI)
- …appropriate resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which… more
- Intermountain Health (Madison, WI)
- …and provides short term treatment planning for mental, emotional and behavioral disorders, conditions and addictions. **Essentials:** + Participates in case ... psychosocial functioning for the purpose of diagnosing mental, emotional, behavioral , addictive and developmental disorders and disabilities, implementing appropriate… more
- Molina Healthcare (Madison, WI)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... multidisciplinary integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports for Molina… more
- Highmark Health (Madison, WI)
- …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... the engagement deliverables, resources, and outcomes. + Develop the engagement business case , scope, staffing and incentive model for RPM engagement with Providers… more
- Molina Healthcare (Madison, WI)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... care review/utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care, health management… more
- Highmark Health (Madison, WI)
- …**LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language (Other than English):** None **Travel ... data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line case management and… more
- Meriter-UnityPoint Health (Madison, WI)
- …the Child and Adolescent (CAP) inpatient units have accountability for the Behavioral Health Therapy team and the Occupational Therapy/Recreation Therapy teams ... + This position also oversees and supports the RN Case Manager for the unit. + The...unit. This includes management of the clinically focused mental health aspects of staff education and new employee orientation.… more
- Molina Healthcare (Madison, WI)
- …years in case , disease or utilization management; managed care; or medical/ behavioral health settings. + One year of training delivery and/or development ... in case , disease or utilization management; managed care; or medical/ behavioral health settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Active,… more
- Highmark Health (Madison, WI)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more