- Public Consulting Group (Charleston, WV)
- …www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible ... publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers… more
- CVS Health (Charleston, WV)
- …comprised of network management, clinical coverage, and policies. The Community Care Case Manager use a collaborative process of assessment, planning, ... to_ _10 to 25%_ _travel_ _within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise_ Help… more
- Holzer Health System (Gallipolis, OH)
- The Case Manager works within a team environment to: (1) Develop, guide and provide case management services, utilize clinical expertise, and coordinate with ... patients to achieve optimal member health . Active Case Management Certification (CCM) or willingness to become certified as a case manager within 2 years more
- Elevance Health (Charleston, WV)
- **Behavioral Health Case Manager II** **Location: West Virginia.** This role enables associates to work virtually full-time, with the exception of required ... ensures essential face-to-face onboarding and skill development. The **Behavioral Health Case Manager II** is responsible for performing case management… more
- CVS Health (Charleston, WV)
- …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 (Charleston, WV)
- …care for members. - This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- Sedgwick (Charleston, WV)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign On Bonus Eligible **We are growing all across the US ... and are looking for experienced Workers Comp Field Case Managers! If you have at least** **1.5 years...with you!** **PRIMARY PURPOSE OF THE ROLE:** Sedgwick Field Case Managers work face to face with their injured… more
- Sedgwick (Charleston, WV)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy,… more
- Otsuka America Pharmaceutical Inc. (Charleston, WV)
- The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to execute against a ... field + Background in advocacy, counseling, nursing, or social work + Case management experience in the specific therapy area + Bilingual skills, particularly… more
- Public Consulting Group (Charleston, WV)
- …that is safe, timely, effective, efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine ... to conduct periodic in person assessments + Facilitates multiple care aspects ( case coordination, information sharing, etc.) + Helps patients make informed decisions… more
- CVS Health (Charleston, WV)
- …all with heart, each and every day. Travel: _Up to 25%_ The Care Manager BH is responsible for driving and supporting care management and care coordination ... review, conducts comprehensive assessments of member's needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and… more
- CVS Health (Charleston, WV)
- …Morgan. Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by ... evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and… more
- Highmark Health (Charleston, WV)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- CVS Health (Charleston, WV)
- …and every day. **Position Summary** **Brief Overview** This is a Hybrid role. The Care Manager RN will be responsible to work from home as well as visit members ... homes. The Care Manager RN is responsible for driving and supporting care...conducts comprehensive assessments of member's needsand recommendsan approach to case resolution by meeting needs in alignment with their… more
- BrightSpring Health Services (Charleston, WV)
- …pre-screening assessments, completion of pre-screening reports, and preparation of case proposals and other related pre-admission paperwork (ie, obtains ... levels with third party payer. + Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's … more
- Highmark Health (Charleston, WV)
- …with external contacts. + Communicate effectively while interacting with Case Management Specialists, Management Team, Physician Advisors and other interdepartmental ... Participate in departmental and/or organizational work and quality initiative teams. + Case collaborate with peers, Case Management Specialists, Management Team,… more
- Cardinal Health (Charleston, WV)
- …Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously ... integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the… more
- Cardinal Health (Charleston, WV)
- …+ Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience + ... Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services + Assist in obtaining… more
- Travelers Insurance Company (Charleston, WV)
- …with insured based on application of policy information to facts or allegations of each case . + Work with Manager on use of Claim Coverage Counsel as needed. ... statements, as strategically appropriate. + Complete outside investigation as needed per case specifics. + Travels frequently inclusive of claim office visits, court… more
- CenterWell (Ona, WV)
- …for normality, fax a copy of lab to doctor, make a copy for the Case Manager , and route to Medical Records Department. Initiate Employee / Patient Infection ... including receiving calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary. + Maintains… more