- CVS Health (Springfield, IL)
- …and strategies, policies and programs are comprised of network management, clinical coverage, and policies. **Position** **Summary/Mission** Our Case Managers ... of Care: * Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and… more
- CVS Health (Springfield, IL)
- …And we do it all with heart, each and every day. **Position Summary** This Clinical Case Manager BH position is with Aetna's Long-Term Services and ... out of Peoria and Tazewell IL. An active Illinois Behavioral Health License is required (LCSW/LCPC). Travel: 50-75% required...Peoria and Tazwell Counties and surrounding areas As a Clinical Case Manager you will… more
- CVS Health (Springfield, IL)
- …as needed/requested by Management. Preference for candidates residing in the Chicago area. Clinical Case Manager RN is responsible for telephonically and/or ... of Care: - Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and… more
- Highmark Health (Springfield, IL)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- CVS Health (Springfield, IL)
- …may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. + Using ... Care Organization experience is strongly preferred. *CCM Certification (Certified Case Manager ) preferred *Crisis intervention skills/experience *Discharge… more
- CVS Health (Springfield, IL)
- …position with 50-75% travel requirement to meet members face to face. As a Case Manager Analyst you will facilitate appropriate healthcare outcomes for members ... outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as...County, IL + Minimum 2 years of experience in behavioral health, social services or human services field +… more
- Centene Corporation (Springfield, IL)
- …or youth foster care or post adoption families as well as case management. **Position Purpose:** Develops, assesses, and facilitates complex care management ... activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and… more
- Highmark Health (Springfield, IL)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Centene Corporation (Springfield, IL)
- …including a fresh perspective on workplace flexibility. **On-Site Opportunity | Senior Care Manager - Transition of Care | Chicago, IL** **Are you a Licensed ... Our Illinois Health Plan is hiring a Senior Care Manager - Transition of Care to work on-site at...etc.) in the state of Illinois** + **Experience in case management and/or utilization management** + **Background in an… more
- Highmark Health (Springfield, IL)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case /utilization management and/or disease/condition management experience, or… more
- Highmark Health (Springfield, IL)
- …Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify ... related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more