- Highmark Health (Jefferson City, MO)
- …the effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in… more
- Highmark Health (Jefferson City, MO)
- …interventions. The incumbent uses clinical and motivational interviewing skills to assess behavioral health , physical health , and social determinants of ... The overall goal is to help members navigate the health care system and develop condition self-management...Participate in ongoing training and educational activities related to behavioral health and medical topics. + Pro-actively… more
- Centene Corporation (Jefferson City, MO)
- …facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare ... plan/service plan for the best outcome, which may include behavioral health and social determinant needs +...to identify providers, specialists, and community resources needed for care including mental health and substance use… more
- CAI (Jefferson City, MO)
- …implement and evaluate care for eligible members with chronic and complex health care , social service and custodial needs in a nursing facility or ... address the member's specific needs. + Educate members or caregivers regarding health care needs, available benefits, resources and services including available… more
- Highmark Health (Jefferson City, MO)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- Highmark Health (Jefferson City, MO)
- …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
- Highmark Health (Jefferson City, MO)
- …Preferred + None **EXPERIENCE** Required + 5 years of clinical or managed care experience Preferred + Health insurance experience **LICENSES OR CERTIFICATIONS** ... position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- Prime Therapeutics (Jefferson City, MO)
- …+ Where applicable, achieves objectives regarding the EAP re-seller agreement. + Supports health plan with behavioral health retail sales. + Identifies ... drives every decision we make. **Job Posting Title** Account Manager - Connecticut ADAP - remote **Job Description Summary**...ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved,… more
- Prime Therapeutics (Jefferson City, MO)
- …+ Where applicable, achieves objectives regarding the EAP re-seller agreement. + Supports health plan with behavioral health retail sales. + Identifies ... work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded… more
- Highmark Health (Jefferson City, MO)
- …in special committee meetings as required. + Cooperates with other health care team members and the Operations Manager pursuant to the Allegheny ... timely manner. + Patients are appropriately referred to other health care support systems or community resources...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Evolent Health (Jefferson City, MO)
- …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be...either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal… more
- CenterWell (Jefferson City, MO)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Sharecare, Inc. (Jefferson City, MO)
- …Specialty Care Providers, ancillary services, and all other members of the health care team to support the members. The certified professional will use ... team by collaborating with PCPs, specialists, other clinicians, and member to meet health care goals through development and implementation of Care Plans.… more
- CenterWell (Jefferson City, MO)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- CenterWell (Jefferson City, MO)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- CenterWell (Jefferson City, MO)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Guardian Life (Jefferson City, MO)
- …contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. ** Health Care ** + Choice of [high deductible/copay] medical plans* ... coverage for fertility and transgender inclusive benefits + Dental plan + Vision plan + Health care accounts - flexible spending, health reimbursement, and … more