- Fallon Health (Worcester, MA)
- …for member experience and service and clinical quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing ... with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider...member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case… more
- Fenway Health (Boston, MA)
- Behavioral Health Substance Use Disorder Specialist Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Behavioral Health ... Under the general supervision of the Manager of Low-Barrier Behavioral Health Services, the Behavioral ...+ Develops and maintains resource listings appropriate for Fenway Health patients + Works with Medicaid, Medicare ,… more
- Fallon Health (Leominster, MA)
- … Medicare , Medicaid, and PACE- in the region. **Brief Summary of Purpose:** The Behavioral Health Clinician provides Behavioral Health services in ... caregivers and SE staff. **Responsibilities** **Primary Job Responsibilities:** * Provides behavioral health support to Summit participants as referred by… more
- Fallon Health (Worcester, MA)
- …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
- Fallon Health (Worcester, MA)
- …tasks; reassignment of work to meet department needs and involvement of navigator and behavioral health case manager resources as appropriate * Ensures ... in home services both skilled and non-skilled, outpatient services including medical and behavioral health , knowledge of different levels of care including but… more
- Highmark Health (Providence, RI)
- …job is responsible for assisting in the processing and investigation of non-complex health care claims to determine the legitimacy of claim charges. The incumbent ... will monitor internal referrals from sources such as claims, customer service, Medicare C&D Compliance, and Fraud Hotlines; will alert Investigators of the need… more
- CVS Health (Boston, MA)
- …for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of ... to thoroughly learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community...with individuals with SDoH needs, chronic medical conditions, and/or behavioral health . + Experience conducting health… more
- Fallon Health (Worcester, MA)
- …in the documentation system **Other:** * Care Management Training Programs Manager behavioral health licensure is responsible to: o Perform clinical supervision ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...for Care Managers that have behavioral health backgrounds on a regular basis,… more
- Boston Health Care for the Homeless Program (Boston, MA)
- … health care, from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than ... to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in greater… more
- Humana (Boston, MA)
- …Management and supports the strategic priorities for Clinical Operations, Medical & Behavioral Health and Humana Government Business (HGB). Leads clinical ... part of our caring community and help us put health first** Reports directly to the Director, Case...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Highmark Health (Providence, RI)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more
- Molina Healthcare (Worcester, MA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... multidisciplinary integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports for Molina… more