- 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)
- …members, up to age 20, who have experienced a behavioral health crisis event. The Clinical Case Manager - BH: Utilizes advanced clinical judgment and ... setting, outpatient clinic, PCP office, or member's residence. The Clinical Care Manager - BH is responsible...clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to… 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)
- …for placement into custodial care. Responsible for implementing and coordinating all case management, psychosocial, and quality of life activities relating to cases ... care services to the members, and to those in case and disease management. Provides psychosocial interventions through resource...(active and unrestricted) in the state of IL: Licensed Clinical Social Worker (LCS) - Ability to occasionally travel… 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)
- …50-75% of the time to meet with members face to face. As a Analyst, Case Manager you will facilitate appropriate healthcare outcomes for members by providing ... outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as...reimbursement policy + Minimum 2 years of experience in behavioral health, social services or human services field +… more
- CVS Health (Springfield, IL)
- …50-75% of the time to meet with members face to face. As a Analyst, Case Manager you will facilitate appropriate healthcare outcomes for members by providing ... impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates… more
- Molina Healthcare (Clinton, IL)
- …waiver services. **Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… 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