- 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 (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)
- …Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate ... of Care: * Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and… 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)
- …Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations ... standard business hours. No weekends and no holidays.** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical… more
- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing ... case management throughout the continuum of care. The case manager will offer guidance. support, and...each beneficiary's capacity for self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care.… 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)
- …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
- 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
- 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
- CVS Health (Springfield, IL)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH)… 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
- CenterWell (Springfield, IL)
- …Medicare/Medicaid experience a plus + Previous experience in utilization management, case management, discharge planning and/or home health or rehab + Certification ... in Case Management a plus (CCM) + Experience working with...go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients'… more
- CenterWell (Springfield, IL)
- …Intelligence Lead and support ad hoc reporting. * Develop basic modeling and business case analysis; work closely with Finance and Data teams * Coordinate with ACO ... that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time… 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