• Clinical Case Manager

    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
    CVS Health (07/05/25)
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  • Behavioral Health Care Manager

    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
    AmeriHealth Caritas (07/01/25)
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  • Complex Case Manager RN - Oncology…

    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 (04/25/25)
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  • Medical Case Manager

    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
    Highmark Health (06/19/25)
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  • Shift Care Nurse Case Manager

    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
    AmeriHealth Caritas (07/01/25)
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  • Case Management Specialist

    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
    CVS Health (06/26/25)
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  • Licensed Clinical Social Worker - Intensive…

    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
    Geisinger (06/21/25)
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  • Care Manager RN (Delaware)

    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 (07/08/25)
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  • Excess Risk Managed Care Clinician

    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
    Highmark Health (07/08/25)
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  • Senior Strategy Advancement Professional

    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
    CenterWell (06/24/25)
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  • Coding Auditor Educator

    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
    Highmark Health (05/09/25)
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