- CVS Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …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
- CVS Health (Frankfort, KY)
- …of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Master's degree in Behavioral /Mental Health or related field. + Unencumbered Behavioral Health clinical license in Kentucky (LCSW, LPCC, LMFT) **Anticipated… more
- Molina Healthcare (Hazard, KY)
- …a current active unrestricted license in the state of KY Case Manager will work remotely supporting Medicaid Behavioral health population. Excellent computer ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's… more
- CVS Health (Jeffersontown, 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 ... 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
- Highmark Health (Frankfort, KY)
- …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
- CVS Health (Florence, KY)
- …all with heart, each and every day. **Position Summary** The High-Fidelity Wraparound (HFW) Case Manager (CM) is a person who safeguards that the principles of ... may impact member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - +… more
- Molina Healthcare (Lexington, 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
- Molina Healthcare (KY)
- …waiver services. **Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... 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
- Molina Healthcare (Louisville, KY)
- …Reviews data to identify principal member needs and works under the direction of the Case Manager to implement care plan. + Schedules member visits with team ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high...+ Screens members using Molina policies and processes, assisting clinical Case Management staff as they identify… more
- Elevance Health (Louisville, KY)
- …Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee ... impact:** + Determines the medical necessity of requests using clinical criteria. + Performs physician-level case review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Valor Health (Bowling Green, KY)
- …in co-managed care collaboration with non-VA providers, and facilities. + Functions as case manager as needed. + Provides patient and family health education ... Psychiatrist Bowling Green, KY (http://maps.google.com/maps?q=600+US+Hwy+31W+Bypass+Bowling+Green+KY+USA+42101) * Clinical - Psychiatrist Apply Job Type Part-time Description… more
- HCA Healthcare (Bowling Green, KY)
- …to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at TriStar Greenview Regional ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- CenterWell (Lexington, KY)
- …represents the scope of provider relationships across the following areas: + Quality/ clinical management and population health + HEDIS and Stars performance + ... without restriction in applicable state + 5+ years of clinical nursing experience + Proven work experience as a...years of managed care experience + 3+ years of case management experience + Bilingual; English and Spanish preferred,… more
- Cumberland River Behavioral Health, Inc. (Corbin, KY)
- …Degree from an accredited college in the areas of Special Education, Behavioral Science or Public Health and 5 years experience in developmental disabilities ... with an ADA based on staff utilized during the year per Instructor and Team Manager and operating a minimum of six (6) hours per day. + Provide inservice training… more
- CenterWell (Frankfort, KY)
- …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 (Frankfort, KY)
- …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
- Sevita (Paducah, KY)
- …participants, and PT/PTA students. + Write service summaries as requested by case manager /program director and maintains daily billing summaries and turns ... etc.; attends other appropriate meetings/conferences as needed. + Attend clinical meetings to exchange, discuss, and evaluate program participant treatment… more
- Sevita (Louisville, KY)
- …participants, and PT/PTA students. + Write service summaries as requested by case manager /program director and maintains daily billing summaries and turns ... etc.; attends other appropriate meetings/conferences as needed. + Attend clinical meetings to exchange, discuss, and evaluate program participant treatment… more