- Molina Healthcare (Omaha, NE)
- …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
- Sharecare (Lincoln, NE)
- …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
- Highmark Health (Lincoln, NE)
- …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 (Lincoln, NE)
- …* 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 (Lincoln, NE)
- …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
- Omaha Children's Hospital (Omaha, NE)
- …Responsible for developing a comprehensive, individualized plan of care and targeted interventions + Implements clinical interventions and protocols based ... including veterans and people with disabilities. **A Brief Overview** The Nurse Case Manager serves the patient population at the organization and is a core team… more
- Sharecare (Lincoln, NE)
- …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 (Lincoln, NE)
- …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 (NE)
- …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
- Omaha Children's Hospital (Omaha, NE)
- …customer satisfaction. **Essential Functions** Performs assessment/reassessment based on clinical indicators and anticipated services for appropriate level of ... hospital care considering safety, quality , and cost. + Meets with the family and...level of care + Reassesses needs and provides appropriate interventions . Monitors and evaluates patient status. + Ensures patient-specific… more
- Healthfirst (NE)
- …and medical necessity of treatments and service utilizations based on clinical documentation, regulatory, and InterQual/MCG criteria + Assessment - identifying ... and recovery + Documenting - documenting all determinations, notifications, interventions , and telephone encounters in accordance with established documentation… more
- Healthfirst (NE)
- …ensure the best individualized care decisions, adherence to timely assessments and interventions for each members changing condition(s) + Build a high performing ... team where clinical , technical and leadership skills are developed and assessed...in the members electronic record. + Participate in the Quality Management Program, identifying performance/process improvement opportunities and recommend… more
- Molina Healthcare (NE)
- …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 (NE)
- …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 ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
- Public Consulting Group (Lincoln, NE)
- …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
- Molina Healthcare (NE)
- …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
- Fresenius Medical Center (Kearney, NE)
- …patient education programs, established social work theory and methods, social work focused interventions , and quality of life measurement instruments as part of ... to patients as permitted within the scope of their clinical training and state license. + Provides educational and...including documentation. + Documents based on MSW interaction and interventions provided to patient and/or family. + Quality… more
- Omaha Children's Hospital (Omaha, NE)
- …etc) to ensure that clinical outcomes are achieved. ◦ Demonstrates clinical competence in administering interventions according to identified standards and ... veterans and people with disabilities. **A Brief Overview** Provides high quality , individualized, family centered care to pediatric patients/families. Care of the… more
- Catholic Health Initiatives (Omaha, NE)
- …quality improvement efforts requiring physician input and/or involvement. ** CLINICAL DOCUMENTATION IMPROVEMENT SUPPORT:** + Educates individual hospital staff ... requested by the healthcare team in order to perform quality and utilization oversight + Perform medical necessity reviews...the case with the attending physician and if additional clinical information is not available, coordinate the process with… more
- Option Care Health (Lincoln, NE)
- …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