- CVS Health (Harrisburg, PA)
- …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
- AmeriHealth Caritas (Harrisburg, PA)
- …visit www.performcare.org and https://pa.performcare.org/ **Role Overview** The PerformCare - PA Behavioral Health Clinical Care Manager (BH-CCM) is ... behavioral health management strategies and solutions to optimize clinical outcomes, maximize efficiency, and integrate services. For more information,… more
- Highmark Health (Harrisburg, PA)
- …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
- Highmark Health (Harrisburg, PA)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** The Pediatric Shift Care Case Manager plays a crucial role in supporting pediatric members and ... and care plans* Experience with community resources* Pediatric experience* Certified Case Manager preferred **LICENSES AND CERTIFICATIONS** **Required** +… more
- AmeriHealth Caritas (Harrisburg, PA)
- **Role Overview** The Care Manager II assists members appropriate for care management and care coordination services in achieving their optimal level of health ... through self-management. ;The Care Manager II is responsible for engaging the member, member...determinants of health and supportive needs + Coordinates physical, behavioral health and social services + Provides medication management,… more
- CVS Health (Harrisburg, PA)
- …Meet regulatory requirements within specified timelines. + **Consults** with the Care Manager RN within the Care Team for clinical knowledge, medication ... supportive clinical decision making + **Collaborates and leverages** the Care Manager RN clinical expertise to ensure members' needs are adequately… more
- Geisinger (Harrisburg, PA)
- …The IOP treatment team is comprised of a psychiatrist, master's level therapist, case manager , and support team members. Job Duties Key IOP responsibilities: ... (IOP) is a short-term program that delivers intensive psychiatric and behavioral health treatment via telemedicine. This patient population is experiencing severe… more
- Highmark Health (Harrisburg, PA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Highmark Health (Harrisburg, PA)
- …**LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language (Other than English):** None **Travel ... **EXPERIENCE** **Required** + 5 years with Any combination of clinical , case management, and/or disease/condition management experience,...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CenterWell (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …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