- Molina Healthcare (Jackson, MS)
- …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...case management or home health experience. * Certified Case Manager (CCM) To all current Molina… more
- Humana (Jackson, MS)
- …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 (Jackson, MS)
- …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
- Molina Healthcare (Jackson, MS)
- … Clinical Social Worker (LCSW) + Advanced Practice Social Worker (APSW) + Certified Case Manager (CCM) + Certified in Health Education and Promotion (CHEP) + ... 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
- CVS Health (Jackson, MS)
- …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
- CenterWell (Jackson, MS)
- …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 (Jackson, MS)
- …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