- Highmark Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …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
- CVS Health (Frankfort, KY)
- …centered thinking and systems of care for those experiencing complex behavioral health challenges. + Experience engaging youth and families in developing, ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....Genuine respect for families of children/youth who have complex behavioral health needs and a firm commitment… more
- CAI (Frankfort, KY)
- …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 (Frankfort, KY)
- …, 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
- Catholic Health Initiatives (Lexington, KY)
- …a system of direct case management to effectively follow patients throughout the continuum of care in a multiple health care delivery system. Role includes ... of Catholic Health Initiatives (CHI) and Dignity Health . With more than 700 care sites...Relations/Guest Service Standards. 10. Demonstrates Core Values Based on Behavioral Standards. 11. Other duties as assigned by management.… more
- LifePoint Health (Georgetown, KY)
- About Us Lifepoint Health 's Central Kentucky market is comprised of four acute care , community-based hospitals, with over 50 outpatient clinics that provide ... advancement to accomplish your career goals. We take pride in personalized patient care backed by high-quality designations to support a culture of safety for both… more
- Highmark Health (Frankfort, KY)
- …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
- Molina Healthcare (Lexington, KY)
- …service worker, Navigator, Assistor, Connecter, Promotora, Marketing, Sales, Growth, , MCO, Managed Care , ACA, FQHC, Behavioral Health , CHW, Community ... opportunities exist and work with One Stop Help Center Manager to develop an outreach strategy to increase and...an Equal Opportunity Employer (EOE) M/F/D/V. Key Words: Healthcare, health care , managed care , … more
- Highmark Health (Frankfort, KY)
- …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
- HCA Healthcare (Frankfort, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... hours volunteering in our communities. As a(an) Clinical Nutrition Manager with Frankfort Regional Medical Center you can be...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Prime Therapeutics (Frankfort, KY)
- …+ 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 (Frankfort, KY)
- …+ 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
- Somatus (Mount Sterling, KY)
- …market-based position. Responsibilities + Works under the guidance of physicians and/or a nurse care manager . + Follow-up with health management plans and ... care team, specifically under the guidance of RN Care Manager and act as an advocate...Preferred + Experience working with patients with chronic and behavioral health needs. + Demonstrated success in… more
- Highmark Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Lexington, KY)
- …practice professionals, pharm D, care coach nurses, medical assistants, behavioral health , specialists, quality-based coders, referral coordinators and more. ... integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- CenterWell (Frankfort, KY)
- …Our care team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, ... integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- HCA Healthcare (Frankfort, KY)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... with Frankfort Regional Medical Center, you can be a manager in an organization that is devoted to giving!...Center offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- CenterWell (Frankfort, KY)
- …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