- CVS Health (Santa Fe, NM)
- …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 (NM)
- …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... or home health experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Case Manager (CCM), **PHYSICAL DEMANDS:** Working environment is… more
- Molina Healthcare (NM)
- …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
- Molina Healthcare (Las Cruces, NM)
- …Suite, organized and analytical thinking . Medicare knowledge/experience is highly preferred. The Case Manager must be able to work in a high-volume environment. ... 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
- Highmark Health (Santa Fe, NM)
- …+ 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
- Molina Healthcare (NM)
- … health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) \#PJNurse \#LI-AC1 To all current Molina ... an integrated delivery of care across the continuum, including behavioral health and long term care, for members with...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Highmark Health (Santa Fe, NM)
- …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
- Magellan Health Services (Albuquerque, NM)
- …criteria for RN, Masters or Doctoral level provider. General Job Information Title Manager , Clinical Care Services- CISC Grade 27 Work Experience - Required ... Responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive… more
- Molina Healthcare (NM)
- …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 (Albuquerque, NM)
- …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
- Aspen Medical (Albuquerque, NM)
- Introduction : Aspen Medical has an exciting opportunity for Clinical Psychologists to partner with us in providing temporary contracted medical services to Military ... a Doctor of Philosophy (PhD) or Doctor of Psychology (PsyD) degree in clinical or counseling psychology from an APA-accredited psychology program or a program… more
- Highmark Health (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …**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 (Roswell, NM)
- …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
- Magellan Health Services (Albuquerque, NM)
- …In State - Other License and Certifications - Preferred CCM - Certified Case Manager - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, RN ... are typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and… more