• Telephonic Behavior Health Care

    Humana (Springfield, IL)
    **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2 , in a telephonic ... the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation… more
    Humana (01/25/25)
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  • Clinical Case Manager Behavioral

    CVS Health (Springfield, IL)
    …Grove area.** **Position Summary** The Clinical Case Manager , Behavioral Health , is responsible for driving and supporting care management and care ... to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning,...Ability to speak to medical and behavioral health professionals to influence appropriate member care .… more
    CVS Health (01/01/25)
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  • Clinical Case Manager Behavioral

    CVS Health (Springfield, IL)
    …channels - Ability to speak to medical and behavioral health professionals to influence appropriate member care . - Utilizes influencing/motivational ... candidates residing in the Chicago area. BH Clinical Case Manager is responsible for telephonically and/or face to face...to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning,… more
    CVS Health (12/05/24)
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  • Telephonic Licensed Social Worker…

    Molina Healthcare (Springfield, IL)
    …under productivity and outcome standards * Promotes integration of services for members including behavioral health care and long term services and supports ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , for members with high need… more
    Molina Healthcare (12/21/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Springfield, IL)
    …implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. + Function in… more
    Highmark Health (01/07/25)
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  • LCPC/LCSW - Foster Care , Care

    Centene Corporation (Springfield, IL)
    …facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare ... plan/service plan for the best outcome, which may include behavioral health and social determinant needs +...to identify providers, specialists, and community resources needed for care including mental health and substance use… more
    Centene Corporation (01/23/25)
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  • Product Manager - Care Management

    Highmark Health (Springfield, IL)
    …Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
    Highmark Health (11/02/24)
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  • Clinical Case Manager RN

    CVS Health (Springfield, IL)
    …channels - Ability to speak to medical and behavioral health professionals to influence appropriate member care . - Utilizes influencing/motivational ... residing in the Chicago, Cook County area. Nurse Case Manager is responsible for telephonically and/or face to face...to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning,… more
    CVS Health (12/05/24)
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  • Complex Case Manager RN - Pediatric…

    Highmark Health (Springfield, IL)
    …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
    Highmark Health (01/25/25)
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  • Facilities Case Manager , LTSS - Licensed…

    Molina Healthcare (Springfield, IL)
    …and suggest changes accordingly. + Promotes integration of services for members including behavioral health care and long-term services and supports, home ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need… more
    Molina Healthcare (01/18/25)
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  • Manager , Program Manager /Product…

    Highmark Health (Springfield, IL)
    …in a project manager role **Preferred** + Leadership experience + Health Care Insurance industry business and operational knowledge + Experience managing ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (01/11/25)
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  • Senior Category Manager

    Highmark Health (Springfield, IL)
    …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
    Highmark Health (12/12/24)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Springfield, IL)
    …for analyzing clinical data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line ... + Analyze clinical data to assess potential stop loss and managed care claim liability and utilize Case Management oversight techniques to ensure front… more
    Highmark Health (11/25/24)
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  • Accreditation Manager

    Humana (Springfield, IL)
    …areas. **Preferred Qualifications** + Experience in managing a team. + Registered Nurse or Behavioral Health professional. + Managed care , Medicaid health ... first** Humana Healthy Horizons is seeking an Accreditation Manager who will oversee and support a team of...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (01/25/25)
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  • Regional Business Manager

    Takeda Pharmaceuticals (Springfield, IL)
    …to take charge of your future at Takeda. Join us as a Regional Business Manager in our Cincinnati, Ohio region. Here, everyone matters, and you will be a vital ... contributor to our inspiring, bold mission. As a Regional Business Manager working on the Gastroenterology Rare Disease Sales Team, you will be empowered to drive… more
    Takeda Pharmaceuticals (01/16/25)
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  • Government Programs Compliance Manager

    NASCO (Springfield, IL)
    **Overview** Under general direction, the Compliance Manager is responsible for operating and improving NASCO's Government Services Compliance Programs through the ... all levels of an organization **Experience:** + 5 years of managed care compliance experience such as Medicare Advantage/Healthcare Exchanges/Medicaid/FEP + 5 years… more
    NASCO (01/28/25)
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  • Patient Food Service Manager

    Compass Group, North America (Springfield, IL)
    …platform includes the latest in healthful eating and an understanding of behavioral change in food consumption. Morrison's alignment with Partnership for a Healthier ... members. Job Summary We are seeking a Patient Services Manager to lead our Patient Services Team in a...experience in food service management preferred in an acute care setting + ServSafe(R) certified, desirable + Possess the… more
    Compass Group, North America (12/21/24)
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  • Complex Care Program Delivery Operations…

    CenterWell (Springfield, IL)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... of senior-focused primary care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on… more
    CenterWell (01/18/25)
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  • Case Management Coordinator - Must live on…

    CVS Health (Springfield, IL)
    …of your health . This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable....**Required Qualifications** + Minimum 2 years of experience in behavioral health , social services or human services… more
    CVS Health (01/24/25)
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  • Analyst, Case Management-Must Reside In Macon,…

    CVS Health (Springfield, IL)
    …of your health . This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with ... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable....resources. **Required Qualifications** -Minimum 2 years of experience in behavioral health , social services or human services… more
    CVS Health (01/21/25)
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