- Molina Healthcare (Jackson, MS)
- …**RED E** **X** **PE** **R** **I** **E** **N** **C** **E:** + 3+ years in behavioral health case management, disease management, managed care settings. + ... case managers/supervisors as needed or required * Case managers in Behavioral Health ...the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's… more
- Molina Healthcare (Jackson, MS)
- …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
- Humana (Jackson, MS)
- …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
- Highmark Health (Jackson, MS)
- …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 (Jackson, MS)
- …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
- Highmark Health (Jackson, MS)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Customer Navigation and Service Senior Product Manager defines the vision, strategy and ... optimizing channel connectivity, and enhancing agent tools. The Senior Product Manager will define the product's value proposition, develop a compelling business… more
- Highmark Health (Jackson, MS)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Billing Product Manager defines and executes the strategy and roadmap for a best-in-class ... define the product's value proposition to develop a compelling business case focused on revenue generation and operational efficiency. Responsibilities include… more
- Intermountain Health (Jackson, MS)
- …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
- Highmark Health (Jackson, MS)
- …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 (Jackson, MS)
- …**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 (Jackson, MS)
- **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
- Molina Healthcare (Jackson, MS)
- …following: Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and ... in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : + If… more