- Elevance Health (Wichita, KS)
- ** Manager , Provider Network Management LTSS ** **Location: Kansas** **Hours:** M - F Standard Working hours **Travel:** Hybrid (1-2 days onsite) 20% ... between providers, members, and the public + Ensures the LTSS provider network has the...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Elevance Health (Olathe, KS)
- ** Network Relations Consultant, LTSS Provider Representative** **Location:** Kansas. This position will work a hybrid model (remote and office). The ideal ... 50 miles of one of our Kansas Elevance Health PulsePoint locations. The ** Network Relations Consultant, LTSS Provider Representative** develops and maintains… more
- Elevance Health (Olathe, KS)
- …with Network Support, Contracting, and Credentialing associates to ensure LTSS credentialing standards are followed, maintaining accurate provider data. + ... ** LTSS Network Education Representative Sr** **Location**... provider training and communication plan, ensuring the provider network has the resources, tools, and… more
- Elevance Health (Olathe, KS)
- …20% Travel with potential overnight as needed The ** LTSS ** **Workforce Development Manager ** is responsible for provider support and oversight as it relates ... ** LTSS Workforce Development Manager ** **Location: Topeka...Provides Workforce Development consulting support and technical assistance to provider organizations. Supports the implementation of provider … more
- Molina Healthcare (Bronx, NY)
- …York LMSW or LCSW licensure. Experience with Long-term Services and Supports ( LTSS ) is highly preferred. Strong organizational and time management skills. The Case ... Manager must have the ability and be comfortable to...physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. +… more
- Elevance Health (Sacramento, CA)
- … provider training + Researches issues that may impact future provider negotiations or jeopardize network retention **Required Qualifications:** + Requires ... Rep; or any combination of education and experience, which would provide an equivalent background. **Preferred Qualifications:** + Provider contracting… more
- AmeriHealth Caritas (Newark, DE)
- …their providers: + Identifying and implementing evidence-based practice guidelines throughout the provider network . + Overseeing the quality of clinical care for ... **Medical Director, LTSS (must reside in DE)** Location: Newark, DE... and non- network providers. + Engaging the provider network in Continuous Quality Improvement through… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Opportunity for an experienced Case Manager in Texas who has worked to request DME equipment for patients. This is a fully telephonic position, ... member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Performs ongoing… more
- Molina Healthcare (Beaumont, TX)
- **JOB DESCRIPTION** **Opportunity for a Registered Nurse to provide Case Management services to our Medicaid members in the Beaumont/Orange, TX, Service Delivery ... member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Performs ongoing… more
- Molina Healthcare (Richmond, TX)
- …member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Performs ongoing ... or social work OR any combination of education and experience that would provide an equivalent background **REQUIRED EXPERIENCE:** + At least 1 year of experience… more
- Humana (Indianapolis, IN)
- … Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with Humana ... explain Humana systems, etc. + Serves as primary relationship manager with LTSS and HCBS providers and/or...provider experience with Humana Healthy Horizons and promote network retention. + Supports new assigned providers with onboarding,… more
- Elevance Health (Grand Prairie, TX)
- …Develops and maintains positive relationships with providers within a local health plan's LTSS provider network . Researches and resolves operational issues. ... + Identifies key opportunities for provider training + Conducts virtual and in-person provider visits to support LTSS network + Functions as a high… more
- Elevance Health (Palo Alto, CA)
- …and maintains positive relationships with providers within a local health plan's LTSS /CalAIM provider network . Researches and resolves operational issues. ... + Identifies key opportunities for provider training + Conducts virtual and in-person provider visits to support LTSS network + Functions as a high… more
- Humana (Tallahassee, FL)
- …goals. The Provider Engagement Professional serves as the primary relationship manager with providers to ensure positive provider experience with Humana ... policies and procedures, explain Humana systems, etc. + Serves as primary relationship manager with LTSS , Skilled Nursing Facilities, HCBS providers and/or PH… more
- CVS Health (Dallas, TX)
- …care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... and programs are comprised of utilization management, quality management, network management, clinical coverage, and policies. + The position...and authorizes services in a cost-effective manner within the LTSS benefit. + The care manager is… more
- VNS Health (Manhattan, NY)
- …cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in ... Works under general supervision. Compensation Range:$85,000.00 - $106,300.00 Annual What We Provide + Referral bonus opportunities + Generous paid time off (PTO),… more
- Molina Healthcare (Tacoma, WA)
- …of the member with hospitalists, outpatient providers, facility staff, and family/support network . + Ensures member transitions to a setting with adequate caregiving ... and medication oversight as required. Works with participating ancillary providers ( LTSS /HCSS, DME), public agencies or other identified service providers to make… more