• Clinical Case Manager

    CVS Health (Springfield, IL)
    …And we do it all with heart, each and every day. **Position Summary** This Clinical Case Manager Behavioral Health position is with Aetna's ... Areas. The requirements is for candidates to hold a Behavioral Health License (specifically , LCSW, LCPC, or LMFT),...outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as… more
    CVS Health (06/17/25)
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  • Clinical Case Manager

    CVS Health (Springfield, IL)
    …Quality of Care: -Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Master's degree in Behavioral /Mental Health or related field** -Unencumbered Independent Behavioral Health clinical license in the state where they work:… more
    CVS Health (06/21/25)
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  • Clinical Case Manager

    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 (06/10/25)
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  • Clinical Case Manager

    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 (04/04/25)
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  • Complex Case Manager RN - (Remote)

    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
    Highmark Health (05/31/25)
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  • Case Management Analyst - Field…

    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
    CVS Health (06/18/25)
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  • Manager , Care Management

    Humana (Springfield, IL)
    …the Director, Case Management and supports the strategic priorities for Clinical Operations, Medical & Behavioral Health and Humana Government Business ... Puerto Rico. + Current valid and unrestricted Registered Nurse license + Certified Case Manager (CCM) + 5 years of healthcare supervisory/management experience,… more
    Humana (06/19/25)
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  • Care Manager , Ltss (RN)

    Molina Healthcare (Springfield, 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
    Molina Healthcare (06/22/25)
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  • LCSW, LCPC - Foster Care, Care Manager

    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
    Centene Corporation (04/03/25)
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  • Care Manager RN

    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
    Highmark Health (06/19/25)
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  • Senior Care Manager Transition of Care

    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
    Centene Corporation (04/12/25)
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  • Coding Auditor Educator

    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
    Highmark Health (05/09/25)
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