- Elevance Health (Cincinnati, OH)
- …health, long term services and supports, and psychosocial needs._ ** Provider Network Manager - LTSS & Contracting** **Location:** This position ... Alternate locations may be considered. The ** Provider Network Manager - LTSS &...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- CVS Health (Phoenix, AZ)
- …partners across Aetna's Medicaid and Medicare lines of business provide national ( LTSS ) Long term support service network oversight for the coordinated and ... for oversight of the execution and adherence to the LTSS network strategy as defined by Aetna...we meet adequacy and other state level requirements for LTSS provider types. + Other duties as… more
- Elevance Health (Mason, OH)
- …with Network Support, Contracting, and external stakeholders to ensure LTSS provider qualification standards are followed, maintaining accurate provider ... health, long term services and supports, and psychosocial needs._ ** Network Education Representative Senior - LTSS ** **Location:**... provider training and communication plan, ensuring the provider network has the resources, tools, and… more
- Elevance Health (Independence, OH)
- …+ Responsible for monitoring LTSS performance across financial, clinical, LTSS network , and operational KPIs, integrating new regulatory requirements within ... the OH MyCare Program. + Lead Care Coordination and LTSS Provider Relations to execute initiatives/innovations and trend mitigation, ensuring compliance with… more
- Molina Healthcare (Irving, TX)
- **JOB DESCRIPTION** Opportunity for TX licensed RN interested in joining our LTSS Team as a Case Manager working with our Medicaid members in the Irving, TX ... for determining the types of services we need to provide . Preference will be given to those candidates with...Preference will be given to those candidates with previous LTSS experience. Mileage is reimbursed as part of our… more
- Molina Healthcare (Des Moines, IA)
- …professional in Council Bluffs, IA metropolitan area to join Molina as a Case Manager working with our Medicaid members. The service delivery area for this position ... for determining the types of services we need to provide . Preference will be given to those candidates with...to those candidates with previous experience working with the LTSS population. Mileage is reimbursed as part of our… more
- Molina Healthcare (Northbrook, IL)
- …who lives in Illinois and must be licensed for the state of Illinois Case Manager will work in remote and field setting supporting our Medicaid Population with. Case ... Manager will be required to physically go to member's...physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. +… more
- Molina Healthcare (IA)
- …member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. + Performs ongoing ... or social work OR any combination of education and experience that would provide an equivalent background **REQUIRED EXPERIENCE:** + At least 1 year of experience… more
- Humana (Lynchburg, VA)
- …strong interpersonal skills. + Serve as primary relationship manager with assigned LTSS and HCBS providers to ensure positive provider experience with Humana ... network providers in Humana's Healthy Horizons in Virginia Medicaid network . This role supports provider onboarding, training, education, and inquiry/issue… more
- CVS Health (Manville, NJ)
- …care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna's Long-Term Services...Nurse position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of… more
- Beth Israel Lahey Health (Exeter, NH)
- …in people's lives.** As a Social Worker within Beth Israel Lahey Health Performance Network , you will have the opportunity to make a profound impact on the lives ... This position is responsible for supporting Beth Israel Lahey Health Performance Network 's (BILHPN) value-based care initiatives within risk contracts and ACO's,… more
- CVS Health (Union, NJ)
- …care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... or $7,500 for all other eligible external candidates._** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Union County and surrounding… more
- CVS Health (Springfield, IL)
- …Providers, Members, Staff and other Leaders both in oral and written formats (eg, may provide support to the sales staff & network staff via onsite customer ... all with heart, each and every day. This Associate Manager , Clinical Health Services position is with Aetna's Long-Term...Services position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of… more
- CVS Health (Fair Lawn, NJ)
- …care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... external candidates who possess NJ Choice Certification._** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Bergen County and… more
- CVS Health (Kearny, NJ)
- …care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... with heart, each and every day. **Position Summary** This is a Field/Remote Case Manager opportunity with 50 to 75% field travel in Hudson County and surrounding… more
- CVS Health (Oakhurst, NJ)
- …care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced… more
- CVS Health (Danville, VA)
- …we do it all with heart, each and every day. **Position Summary** This Case Manager RN/LPN position is with Aetna's Long-Term Services & Support ( LTSS ) team and ... a current unrestricted Virginia state RN or LPN licensure. Nurse Case Manager is responsible for assessing, planning, implementing and coordinating all case… more
- CVS Health (Dallas, TX)
- …care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. + The position...and authorizes services in a cost-effective manner within the LTSS benefit. + The care manager is… more
- CVS Health (Dallas, TX)
- …care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. ... develop a care plan and authorizes services in a cost-effective manner within the LTSS benefit. The care manager is responsible for documenting accurately and… more
- Molina Healthcare (MS)
- …of the member with hospitalists, outpatient providers, facility staff, and family/support network . + Ensures member transitions to a setting with adequate caregiving ... and medication oversight as required. Works with participating ancillary providers ( LTSS /HCSS, DME), public agencies or other identified service providers to make… more