- Commonwealth Care Alliance (Boston, MA)
- …and drive both program-wide and provider -specific performance improvement. The LTSS Program Manager reports to the Senior Director of Delegation ... 011150 CCA-Network Contracting **Position Summary:** The LTSS Program Manager is responsible for...+ Serve as the primary liaison for assigned community-based LTSS provider organizations, with a focus on… more
- Commonwealth Care Alliance (Boston, MA)
- …and utilization management systems and workflows. - Experience managing delegated provider contracts and oversight programs. - Project management skills ... 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the… more
- Molina Healthcare (West Union, IA)
- JOB DESCRIPTION Opportunity for an experienced Care Manager to join the LTSS team with our Iowa Health Plan. Responsibilities include conducting face-to-face ... to determine the types of services we need to provide and managing their care until they are discharged...The ideal candidate will have experience as a Care Manager within a managed care organization (MCO) like Molina… more
- Molina Healthcare (Warren, MI)
- …. * Identified as contract system lead by developing and maintaining provider contracts in contract management software. * Targets and recruits ... in the negotiation of medical group/IPA and hospital contracting. * Advises Network Provider Contract Specialists on negotiation of individual provider and… more
- AmeriHealth Caritas (Detroit, MI)
- …the supervision of the Manager LTSS , the Supervisor, Medicare LTSS Operations is responsible to provide operational oversite and process improvement ... more about us at www.amerihealthcaritas.com. **Responsibilities:** The Supervisor, Medicare LTSS Operations is responsible for ensuring and improving the… more
- Elevance Health (KS)
- **RN Case Manager ( LTSS Service Coordinator- RN Clinician)** Location: Seeking candidates to reside in Montgomery, Elk, Wilson, and/or Chautauqua County Kansas. ... responsiveness to client needs, and direct, hands-on engagement. The **RN Case Manager ** is responsible for overall management of member's case within the scope… more
- CVS Health (Harrisburg, PA)
- …with knowledge of basic negotiating skills. + Proven working knowledge of standard provider contracts , terms, and language. + High proficiency with Microsoft ... and meet network adequacy and expansion goals. + Audit, build, and load contracts , agreements, amendments, and/or fee schedules in contract management systems.… more
- Humana (Indianapolis, IN)
- …caring community and help us put health first** The Strategy Advancement Advisor LTSS Program Manager provides data-based strategic direction to identify and ... regulator, plan leadership, and the enterprise to ensure the execution of contract deliverables and operational changes when requested by regulator or deemed… more
- Elevance Health (IN)
- ** LTSS Service Coordinator (Case Manager )** **Location:** Seeking candidates to work in Greene, Daviess, Martin, Dubois, Pike, Knox Counties in Indiana. ... responsiveness to client needs, and direct, hands-on engagement. The ** LTSS Service Coordinator (Case Manager )** is responsible... needs, as required by applicable state law and contract , and federal requirements. **How you will make an… more
- Centene Corporation (Austin, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... . **Licensed Behavioral Health Professional or RN based on state contract requirements: LCSW, LPC or RN with direct Behavioral Health experience… more
- Centene Corporation (Topeka, KS)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... **License/Certification:** + Licensed Behavioral Health Professional or RN based on state contract requirements eg, LCSW, LMFT, LMHC, LPC and/or RN with BH… more
- Elevance Health (Akron, OH)
- …and maintains positive relationships with providers within a local health plan's LTSS /HCBS provider network. Researches and resolves operational issues. **How ... area needs + Acts as a liaison to support contract execution + Identifies key opportunities for provider... provider training + Conducts virtual and in-person provider visits to support LTSS network +… more
- Elevance Health (Corpus Christi, TX)
- …responsibility for the member's case. As required by applicable state law and contract , the Clinician contributes to the LTSS care coordination process by ... ** LTSS Service Coordinator - Clinician** **Location:** This is...or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted LPN/LVN, LSW,… more
- Elevance Health (Trenton, NJ)
- …responsibility for the member's case. As required by applicable state law and contract , the Clinician contributes to the LTSS care coordination process by ... ** LTSS Service Coordinator - Clinician** **Location:** The location...or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted LPN/LVN, LSW,… more
- Elevance Health (Middletown, NY)
- ** LTSS Service Coordinator - RN Telehealth** **_Location:_** candidate must reside in the tri-state area (NY, NJ, or CT). **_Virtual:_** This role enables associates ... an accommodation is granted as required by law._ The ** LTSS Service Coordinator - RN Telehealth** is responsible for...member's case in accordance with applicable state law and contract ; develops , monitors, evaluates, and revises the member's… more
- Compass Maryland (Beltsville, MD)
- …Benefits Counseling partners until CWIC/CPWIC certification is obtained and DORS fee-for-service contract is active. Once active, provide Benefits Counseling to ... of Strategic Partnerships. Essential Job Requirements Include : + Provide Housing Support Services to an initial maximum caseload...procedures. + Experience with OneDrive, SharePoint, Microsoft Word, Excel, LTSS , and I Care Manager or similar… more
- Molina Healthcare (GA)
- …management, behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs. Ensures members reach desired outcomes ... of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Responsible for… more
- Commonwealth Care Alliance (Boston, MA)
- …and utilization management systems and workflows. * Experience managing delegated provider contracts and oversight programs. * Project management skills ... 011230 CA- Provider Engagement & Performance Position Summary: The Provider Delegation Performance Manager is responsible for overseeing and improving the… more
- Elevance Health (Sylva, NC)
- …REQUIRED! **$5,000 SIGN ON BONUS** **LOCATION** **: We are seeking a Manager to cover** **Swain/Graham/Clay/Macon counties.** **Residency in one of these counties is ... an accommodation is granted as required by law._ The Manager Care Management ( Manager I GBD Special...complex health and social needs. + Ensure care managers provide Trauma-Informed Care and recognize the impact of ACEs… more
- Molina Healthcare (Yonkers, NY)
- …overarching strategy to provide quality and cost-effective member care. The Care Manager will be supporting our New York HARP Adult Behavioral Health program. We ... JOB DESCRIPTION **Job Summary** The Care Manager (BH) provides support for care management/care coordination...for members including behavioral health, long-term services and supports ( LTSS ), and home and community resources to enhance continuity… more
