- Molina Healthcare (Covington, KY)
- …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
- Elevance Health (Louisville, KY)
- … data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals. + Serves as a clinical resource to other pharmacists and ... providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions . + Prepares information for network… more
- Sharecare (Frankfort, KY)
- …support in an appropriate, efficient and cost-effective manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary ... total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible… more
- ChenMed (Louisville, KY)
- …indicators. + Fosters growth and effectiveness of Pharmacy work teams to meet quality and clinical care standards/ + Assists Pharmacy leadership in ensuring ... rapidly expanding and we need great people to join our team. The Clinical Pharmacist specializing in Population Health is a skilled and proactive professional who… more
- STG International (Hopkinsville, KY)
- STGi is currently seeking a Licensed Clinical Social Worker to provide services for a Community Based Outpatient Clinic in Hopkinsville, KY. The clinic operates ... The general duty of the Medical Social Worker (MSW)/Licensed Clinical Social Worker (LCSW) is to provide social work...+ Provide crises intervention, supportive counseling and problem solving interventions as applicable. + Serve as a member of… more
- Highmark Health (Frankfort, KY)
- …referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates ... and member satisfaction. Responds to customer inquiries and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management… more
- Public Consulting Group (Frankfort, KY)
- …* Document all care activity via case management software system * Promotes quality and cost-effective interventions and outcomes * Assesses and addresses ... a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible...accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes +… more
- Highmark Health (Frankfort, KY)
- …to appropriate multi-disciplinary resources. In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an ... performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members… more
- Molina Healthcare (Lexington, KY)
- **Job Description** We are looking for a Case Manager (licensure required LCSW, LPCC, and LMFT) who must reside in Kentucky. Will work telephonically supporting SMI ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Sharecare (Frankfort, KY)
- …2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program ... in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- Molina Healthcare (KY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Completes clinical assessments of members per regulated timelines and determines who may qualify… more
- Molina Healthcare (Owensboro, KY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... Suite and computer savvy is very helpful. The Case Manager must be able to work in a high-volume...determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness,… more
- Molina Healthcare (KY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. + Promotes integration… more
- Molina Healthcare (KY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. + Promotes integration… more
- Public Consulting Group (Frankfort, KY)
- …complete accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes + Assesses and ... informed decisions by acting as their advocate regarding their clinical status and treatment options + Develops effective working...management, including as a nurse, medical, mental health care manager or a related job + Excellent knowledge of… more
- Option Care Health (Frankfort, KY)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the ... professional who is responsible for the development and implementation of clinical , operational, and marketing strategies to promote the home nutrition support… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- Summary This position provides high- quality case management, clinical treatment, advocacy, and coordination of linkages to other appropriate VA or community ... in committee assignments, as deemed necessary by the service manager . Maintain data and statistical compilations to comply with...at least two years of experience post advanced practice clinical licensure and should be in a specialized area… more
- HCA Healthcare (Lexington, KY)
- …care. Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** + Assesses home ... and patient/family/caregiver. + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings,… more
- ChenMed (Louisville, KY)
- …directors to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required ... impact on patient health outcomes. The PCP stays up to date on clinical , nutritional, and lifestyle-based interventions to improve outcomes. + Physician… more
- Highmark Health (Frankfort, KY)
- …performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a… more