- Centene Corporation (Dover, DE)
- …with up to 40% field based work. _** **Position Purpose:** Supervises the care coordination team that serves long-term care members with physical/medical health ... needs and/or behavioral/mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management… more
- AmeriHealth Caritas (Detroit, MI)
- …for ensuring and improving the performance, productivity and efficiency of Medicare LTSS Care Coordination Operations. Under the supervision of the Manager ... LTSS , the Supervisor , Medicare LTSS ...services. + Ensures effective daily operation of the Medicare LTSS Care Coordination team complying with all… more
- Molina Healthcare (Dayton, OH)
- …in-office work is required. + Preferred experience with MyCare Ohio and LTSS . **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible ... with Molina policies/procedures or CMS guidelines/regulations, or to assess the non- clinical quality of customer service provided to Molina members. * Provides… more
- UPMC (Camp Hill, PA)
- …working from home and in office. Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and supports ( LTSS ) program serving seniors and ... UPMC Health Plan is looking for Service Coordinator Supervisor positions to join the Community HealthChoices team...information. + Responsible for the operational functions of the LTSS Team primarily focused on the service coordination model… more
- Molina Healthcare (GA)
- …the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other ... JOB DESCRIPTION **Job Summary** The Supervisor , Healthcare Services UM leads and supervises a...care transitions, behavioral health, long-term services and supports ( LTSS ), or equivalent combination of relevant education and experience.… more
- Molina Healthcare (Chicago, IL)
- …the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other ... care transitions, behavioral health, long-term services and supports ( LTSS ), or equivalent combination of relevant education and experience. r equivalent… more
- Highmark Health (Dover, DE)
- …and to promote effective use of resources for members enrolled in DSHP Plus LTSS . Provides direct oversight to Case Managers, meets all of the requirements of a ... the day to day activities as needed. + Ensure care is medically appropriate, high quality, and cost effective....quality assurance, and to identify training opportunities. + Apply clinical knowledge to work with facilities and providers for… more
- AmeriHealth Caritas (Detroit, MI)
- …at www.amerihealthcaritas.com. **Role Overview: ;** Reporting to the Supervisor of Medicare LTSS Operations, the Medicare LTSS Care Coordinator manages ... LTSS ), and psychosocial needs. This role ensures that care is delivered by Centers for Medicare & Medicaid...for Medicare members receiving LTSS and custodial care . + Conduct telephonic and in-person clinical … more
- Molina Healthcare (Los Angeles, CA)
- …the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports ( LTSS ), and/or other ... care UM processes. * Medicaid/Medicare population experience. * Clinical experience. * Supervisory/leadership experience. **Work Schedule: Pacific daytime… more
- CVS Health (IL)
- …compassionate. And we do it all with heart, each and every day. The Supervisor is responsible for oversight of LTSS /Waiver healthcare case management staff ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Commonwealth Care Alliance (Boston, MA)
- …more years of Home Health Care experience + 2 or more years of LTSS experience + 2 or more years working in a Medicare Advantage health Plan **Required ... Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making.… more
- BrightSpring Health Services (Fayetteville, NC)
- …+ Develops positive relationships among and between members, family/guardians, Extenders, clinical and care team members and other community stakeholders ... events that align with minimum contact expectations to the Care Management Supervisor . + Maintains an accurate,...degree accumulated experience with the IDD population; and For care managers serving members with LTSS needs:… more
- CVS Health (Bassett, VA)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Nurse position is with Aetna's Long-Term Services and Supports ( LTSS ) team and is a field-based position out of...policies and programs are comprised of network management and clinical coverage policies. Through the use of clinical… more