- National Youth Advocate Program (Louisville, KY)
- …the Office of Refugee Resettlement (ORR), NYAP's **Post Release Services (PRS) Intensive Case Manager Level 3** provides post release services focused on ... and intensive case management. The PRS Intensive Case Manager Level 3 will additionally connect...degree in social work, psychology, sociology, or other relevant behavioral science in which direct clinical experience… more
- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical ... health and behavioral healthcare through assessment and care planning, direct provider...or Company. **Required qualifications:** + 3 years of direct clinical practice experience post master's degree + Requires knowledge… more
- Molina Healthcare (Louisville, KY)
- …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...Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... case management throughout the continuum of care. The case manager will offer guidance, support, and...beneficiary's capacity for self- care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care.… more
- CVS Health (Frankfort, KY)
- …it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in ... to facilitate and support the member's improved health. The Case Manager develops a proactive course of...policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that… more
- Molina Healthcare (Louisville, KY)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or… more
- Elevance Health (Louisville, KY)
- …for clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers ... ** Behavioral Health Medical** **Director-Psychiatrist** **Appeals** **Location:** This role...manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews.… more
- Molina Healthcare (Louisville, KY)
- …to navigate online portals and databases. **Preferred Qualifications** * Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), ... **JOB DESCRIPTION** **Job Summary** This position will be focused on Clinical Program Design. Provides subject matter expertise and leadership to healthcare services… more
- Molina Healthcare (Louisville, KY)
- …a current active unrestricted license in the state of KY Case Manager will work remotely supporting Medicaid Behavioral health population. Excellent computer ... software program(s) proficiency. **PREFERRED QUALIFICATIONS:** * Certified Case Manager (CCM). * Experience in behavioral health care management.… more
- Molina Healthcare (Louisville, KY)
- …Nurse who lives in Kentucky and must be licensed for the state of Kentucky Case Manager RN will work with KY Medicaid population providing telephonic case ... health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- Highmark Health (Frankfort, KY)
- …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
- Molina Healthcare (Louisville, KY)
- …be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed ... suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and… more
- Select Medical (Madison, IN)
- …programs and Behavior Intervention Plans directed by a Board Certified Behavior Analyst (BCBA)/ Case Manager . All therapists are supervised by the BCBA/ Case ... in 40 states, plus the District of Columbia. Our highly respected clinical team provides preventative and rehabilitative services that maximize functionality and… more
- Highmark Health (Frankfort, KY)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case /utilization management and/or disease/condition management experience, or… more
- CenterWell (Frankfort, KY)
- …and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization… more
- Elevance Health (Louisville, KY)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... oversight from immediate manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews. + Typically has program… more
- Sharecare (Frankfort, KY)
- …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... A Disease Management Nurse is supervised by an Operations Manager (OM). All Sharecare clinicians are required to participate...during the training period will be evaluated on a case by case basis and must be… more
- State of Indiana (Madison, IN)
- …Life: The essential elements of the job duties: + Serve as social worker and/or case manager and perform mental health assessments of patients. + Gather needed ... both reduce the risks associated with polypharmacy and optimize clinical outcomes. The hospital clinical and medical...of social work and recovery. + Specialized knowledge of case management, assessment, and continuum of care. + Practical… more
- Molina Healthcare (Louisville, KY)
- …Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) Work schedule :M - F Pacific ... 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
- HCA Healthcare (Frankfort, KY)
- …to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Frankfort Regional Medical ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...and special projects as assigned by the RN, Nurse Manager or Director. What qualifications you will need: +… more
