• Medicare Behavioral Health

    Fallon Health (Worcester, MA)
    …for member experience and service and clinical quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing ... with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider...member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case more
    Fallon Health (04/16/25)
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  • Behavioral Health Clinician - 55+…

    Fallon Health (Leominster, MA)
    Medicare , Medicaid, and PACE- in the region. **Brief Summary of Purpose:** The Behavioral Health Clinician provides Behavioral Health services in ... caregivers and SE staff. **Responsibilities** **Primary Job Responsibilities:** * Provides behavioral health support to Summit participants as referred by… more
    Fallon Health (05/07/25)
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  • Senior Care Options Nurse Case Manager…

    Fallon Health (Milford, MA)
    …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
    Fallon Health (05/16/25)
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  • RN Case Manager

    Covenant Health (Nashua, NH)
    … Manager works closely with, and delegates care to, the High-Risk Social Worker/ Behavioral Health Clinician because of assessment and determination of social ... Summary RN Case Managers provide a systematic collaborative approach to...to receive services. + Delegates cases to High-Risk Social Worker/ Behavioral Health Clinician based on assessment including… more
    Covenant Health (03/08/25)
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  • Telephonic Nurse Case Manager

    Humana (Boston, MA)
    …of contact for the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate with other Medical Management ... part of our caring community and help us put health first** The **Telephonic Nurse Case Manager**...(SDOH). Plan shall include psychosocial issues, home environment and behavioral health needs across the full continuum… more
    Humana (05/20/25)
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  • Social Worker (LICSW or LCSW) - Care Coordinator

    Beth Israel Lahey Health (Wakefield, MA)
    …collaboration with contracted Managed Care Organizations as well as Community Partners for Behavioral Health and Long Term Services and Supports, as appropriate. ... + Provides care coordination for individuals with multiple social stressors and/or behavioral health concerns. Utilizes screening criteria developed for the… more
    Beth Israel Lahey Health (04/03/25)
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  • High-Acuity Community Health Worker

    Fenway Health (Boston, MA)
    …Consults with a variety of health center and community staff (Nutritionists, Home Health Aides, Nurses, Behavioral Health staff and Medical staff) about ... Coordination Nurse Manager and High Acuity Social Worker, the High Acuity Community Health Worker provides low barrier case management, health navigation… more
    Fenway Health (03/07/25)
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  • Government Programs Eligibility & Business Office…

    Cambridge Health Alliance (Cambridge, MA)
    …and high-functioning interdisciplinary team to provide fully integrated medical and behavioral health care, community resources, and in-home support services. ... * Collaborate on an interdisciplinary level with our Quality and Compliance, Health Plans Operations, Clinical Operations, and Case Management teams to… more
    Cambridge Health Alliance (05/17/25)
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  • Program Coordinator

    Beth Israel Lahey Health (Burlington, MA)
    …during the program. These records must be maintained using the ACGME Case Log System.** **Manages the Milestones implementation and collection process in ACGME ... Database for ACGME compliance and Finance Department reference for Annual Medicare Cost Report submission.** **Tracks Quality Improvement and Patient Safety projects… more
    Beth Israel Lahey Health (04/12/25)
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  • Coding Auditor Educator

    Highmark Health (Boston, MA)
    **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more
    Highmark Health (05/09/25)
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