- 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
- 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
- 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
- Molina Healthcare (Santa Fe, 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
- 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 (Santa Fe, 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 (Santa Fe, 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