- Molina Healthcare (NM)
- …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
- Aspen Medical (Albuquerque, NM)
- Introduction : Aspen Medical has an exciting opportunity for Clinical Psychologists to partner with us in providing temporary contracted medical services to Military ... Philosophy (PhD) or Doctor of Psychology (PsyD) degree in clinical or counseling psychology from an APA-accredited psychology program...clinic's health care team and assist the primary care manager (PCM) in managing the overall health of their… more
- Sharecare (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …* 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 (Santa Fe, NM)
- …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
- Magellan Health Services (NM)
- …discharge plans and oversee their implementation. + Performs quality clinical reviews while educating and making appropriate interventions to advance ... quality of care. General Job Information Title Care Manager , BH Grade 24 Work Experience - Required ...Manager , BH Grade 24 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate… more
- Sharecare (Santa Fe, NM)
- …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 (Rio Rancho, NM)
- …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 (NM)
- …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
- Healthfirst (NM)
- …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 (NM)
- …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 (Albuquerque, NM)
- …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
- Molina Healthcare (Ruidoso, NM)
- …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 (NM)
- …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 (NM)
- …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 (Santa Fe, NM)
- …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
- Fresenius Medical Center (Alamogordo, NM)
- …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
- Magellan Health Services (Taos, NM)
- …with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical , social and community ... identify gaps in care, trends to improve health and quality of life outcomes. + Collects clinical ...including the Interdisciplinary Care Plan team, to ensure appropriate interventions , cost effective delivery of quality care… more
- Fresenius Medical Center (Albuquerque, NM)
- …patient education programs, established social work theory and methods, social work focused interventions , and quality of life measurement instruments as part of ... care team to promote positive adjustment, rehabilitation, and improved quality of life for our patients. As well as...well as a leadership path from Social Worker to Manager , Senior Manager and Senior Director. **Our… more