- Centene Corporation (Tallahassee, FL)
- …that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management ... related to members or providers. + Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and… more
- Centene Corporation (Dover, DE)
- …health needs and/or behavioral/mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care ... related to members or providers. + Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and… more
- AmeriHealth Caritas (Detroit, MI)
- …for ensuring and improving the performance, productivity and efficiency of Medicare LTSS Care Coordination Operations. Under the supervision of the Manager ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...services. + Ensures effective daily operation of the Medicare LTSS Care Coordination team complying with all… more
- Molina Healthcare (Dayton, OH)
- …such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care , and correct coding. * Independently ... in-office work is required. + Preferred experience with MyCare Ohio and LTSS . **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible… more
- AmeriHealth Caritas (Scranton, PA)
- … and services.; + Maintains operational processes, policies, and procedures to support LTSS care delivery + Ensure quality and performance metrics are ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...Participants.; + Serves as a subject matter expert for LTSS training for internal care teams and… more
- UPMC (Camp Hill, PA)
- …working from home and in office. Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports ( LTSS ) program serving seniors and ... UPMC Health Plan is looking for Service Coordinator Supervisor positions to join the Community HealthChoices team...information. + Responsible for the operational functions of the LTSS Team primarily focused on the service coordination model… more
- Centene Corporation (Topeka, KS)
- …that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management ... candidate will have a Bachelor's degree and previous case management experience, preferably working with the LTSS ...to members or providers. + Monitors and reviews long-term care management required documentation to maintain and… more
- Molina Healthcare (GA)
- … care management , utilization management , behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs. ... MUST reside in Georgia **Essential Job Duties** + Assists in implementing health management , care management , utilization management , behavioral health… more
- Molina Healthcare (Los Angeles, CA)
- … care management , utilization management , behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other special programs. ... member care . **Essential Job Duties** * Assists in implementing health management , care management , utilization management , behavioral health… more
- Highmark Health (Dover, DE)
- …and to promote effective use of resources for members enrolled in DSHP Plus LTSS . Provides direct oversight to Case Managers, meets all of the requirements of a ... the day to day activities as needed. + Ensure care is medically appropriate, high quality, and cost effective....population + Two years in home clinical or case management experience + Medicare and Medicaid experience + Managed… more
- AmeriHealth Caritas (Detroit, MI)
- …at www.amerihealthcaritas.com. **Role Overview: ;** Reporting to the Supervisor of Medicare LTSS Operations, the Medicare LTSS Care Coordinator manages ... those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty...LTSS ), and psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid… more
- Commonwealth Care Alliance (Boston, MA)
- …CCM (Certified Case Manager) **Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care setting + 2 or more years ... Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...Care experience + 2 or more years of LTSS experience + 2 or more years working in… more
- BrightSpring Health Services (Fayetteville, NC)
- …documentation of billable events that align with minimum contact expectations to the Care Management Supervisor . + Maintains an accurate, up-to-date ... concern, general departmental activities and staffing needs to the Care Management Supervisor . + Completes...years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management… more
- Elevance Health (NC)
- …services, long term services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina where all children ... accommodation is granted as required by law._ **The Manager Care Management , Foster Care ** (Manager...very strongly preferred. + At least 2 years of management / supervisor experience (with direct reports) is needed… more
- CVS Health (Bassett, VA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Case Manager Registered Nurse position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of the Martinsville and… more
- AmeriHealth Caritas (Newark, DE)
- …care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral ... healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care , stay well, and build healthy communities. As one of the nation's leaders… more
- CVS Health (IL)
- …each and every day. The Supervisor is responsible for oversight of LTSS /Waiver healthcare case management staff including the organization and development of ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more