- 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 (Harrisburg, PA)
- …Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations ... standard business hours. No weekends and no holidays.** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical… 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
- CVS Health (Harrisburg, PA)
- …impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates ... Morgan. Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by… 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
- Intermountain Health (Harrisburg, PA)
- **Job Description:** The Nurse Care Manager works collaboratively with physicians and other members of the health care team to improve the health of patients with ... addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. **Job Specifics** + Pay Range: $40.39… more
- Highmark Health (Harrisburg, PA)
- …Practice/ clinical Directors, Practice/ clinical Managers, senior leadership, Coding Manager , hospital case management, managed care contracting and RCC ... documentation & billing processes; collaborates and helps to optimize clinical documentation through analysis and prioritized evaluation. Assists with maintaining… 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