• Behavioral Health Case

    Elevance Health (West Des Moines, IA)
    …clinicians and business leaders passionate about transforming American healthcare delivery._ **Title** : Behavioral Health Case Manager I **Location:** ... late shift per week. **Build the Possibilities. Make an Extraordinary Impact.** The ** Behavioral Health Case Manager I** is responsible for performing… more
    Elevance Health (03/08/25)
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  • Behavioral Health Case

    Elevance Health (West Des Moines, IA)
    The ** Behavioral Case Manager I** is responsible for performing case management with members in person and telephonically within the scope of licensure ... for members with behavioral health and substance abuse disorder needs....territory of the United States required. + Experience in case management and telephonic and/or in person coaching with… more
    Elevance Health (01/22/25)
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  • Manager , Utilization Management…

    Humana (Des Moines, IA)
    …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
    Humana (03/12/25)
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  • Remote Program Manager , HCS - RN…

    Molina Healthcare (Des Moines, IA)
    …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 (03/04/25)
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  • (Registered Dietician) Health Management…

    Molina Healthcare (Des Moines, IA)
    **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 (03/04/25)
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  • Complex Case Manager RN (Remote)

    Highmark Health (Des Moines, IA)
    …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
    Highmark Health (03/13/25)
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  • Case Manager , RN

    CAI (Des Moines, IA)
    …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
    CAI (02/01/25)
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  • Case Manager , LTSS (Must Reside…

    Molina Healthcare (Des Moines, IA)
    …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 (03/13/25)
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  • Care Manager RN (Delaware) Remote

    Highmark Health (Des Moines, IA)
    …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
    Highmark Health (02/20/25)
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  • Social Work Care Manager

    Intermountain Health (Des Moines, IA)
    …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
    Intermountain Health (03/15/25)
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  • Manager , Healthcare Services (Remote)

    Molina Healthcare (Des Moines, IA)
    …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
    Molina Healthcare (03/07/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Des Moines, IA)
    …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
    Highmark Health (03/06/25)
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  • Manager , HCS Operations Support Remote…

    Molina Healthcare (Des Moines, IA)
    …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
    Molina Healthcare (03/13/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Des Moines, IA)
    …**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
    Highmark Health (02/24/25)
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  • Peer Support Specialist (Certification Required)

    Elevance Health (West Des Moines, IA)
    …in forming a supportive, peer recovery network. + Assist members in working with their case manager or treatment team in determining the steps he/she needs to ... AA/AS and minimum of 2 years of experience in health services or behavioral health ...both written and verbal. + Knowledge of care-coordination and case management concepts strongly preferred. + BA/BS or MBA… more
    Elevance Health (02/08/25)
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  • Trainer - Clinical Services - Utilization Review…

    Molina Healthcare (Des Moines, IA)
    …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
    Molina Healthcare (03/13/25)
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  • Chemical Dependency Counselor

    Trinity Health (Des Moines, IA)
    …appropriate professional boundaries with all persons involved. + Serves as a case manager where appropriate. + Provides crisis intervention and conflict ... skills, etc. Determines need for outside professional evaluations (eg, mental health ), and independently refers to appropriate care providers, agencies, etc. as… more
    Trinity Health (03/04/25)
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  • Coding Auditor Educator

    Highmark Health (Des Moines, IA)
    **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
    Highmark Health (02/07/25)
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  • RN - TX Licensure - Transition of Care Coach

    Molina Healthcare (Des Moines, IA)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) _This role is currently 100% remote_… more
    Molina Healthcare (02/22/25)
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