- CVS Health (Harrisburg, PA)
- …Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate ... of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and… more
- CVS Health (Harrisburg, PA)
- …hours. No weekends and no holidays.** + **Master's Degree and Independently Licensed in Behavioral Health** + **3 or more years clinical experience in ... Behavioral Health** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral … more
- Highmark Health (Harrisburg, PA)
- …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
- CVS Health (Harrisburg, PA)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- CVS Health (Harrisburg, PA)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH)… more
- Humana (Harrisburg, PA)
- …is dedicated to designing, developing, and implementing innovative learning solutions for clinical associates across Medicaid markets. As a Manager of Learning ... ( Manager , Learning Design) within Clinical Operations, you will collaborate with enterprise leaders and key stakeholders to lead a high-performing team in… more
- WellSpan Health (Shippensburg, PA)
- …of clinical staff; approves/disapproves scheduled time off. + Assists Manager and Clinical Operations Coordinator with interviewing, hiring, orienting, ... part of the management team, performing a variety of clinical and administrative duties related to clinical ...Diagnostic Test Tracking, Med Reconciliation and PCMN. + Assumes manager role when Practice Manager /Front Office Supervisor… more
- WellSpan Health (Gettysburg, PA)
- …of clinical staff; approves/disapproves scheduled time off. + Assists Manager and Clinical Operations Coordinator with interviewing, hiring, orienting, ... part of the management team, performing a variety of clinical and administrative duties related to clinical ...Diagnostic Test Tracking, Med Reconciliation and PCMN. + Assumes manager role when Practice Manager /Front Office Supervisor… more
- Highmark Health (Harrisburg, PA)
- …the enhanced Nurse Licensure Compact (eNLC). **Preferred** + ACM Certification (Accredited Case Manager ) **SKILLS** + Adult Learning: Theory and Practice + ... Description :** **JOB SUMMARY** This job delivers highly complex clinical and systems training courses, ongoing workshops in support...Work **EXPERIENCE** **Required** + 3 - 5 years in Case Management **Preferred** + 5 - 7 years in… more
- Highmark Health (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …dollar and strategic contracting functions (client and GPO), develops business case and presents to senior leadership throughout organization. + Monitor contract ... of major commodity contracts for a wide array of clinical and non- clinical products and/or services. Experience...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Harrisburg, PA)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case /utilization management and/or disease/condition management experience, or… more