- Molina Healthcare (Lexington, KY)
- …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
- Sharecare (Frankfort, KY)
- …support in an appropriate, efficient and cost-effective manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary ... total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible… more
- Highmark Health (Frankfort, KY)
- …referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates ... and member satisfaction. Responds to customer inquiries and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management… more
- Public Consulting Group (Frankfort, KY)
- …* Document all care activity via case management software system * Promotes quality and cost-effective interventions and outcomes * Assesses and addresses ... a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible...accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes +… more
- Highmark Health (Frankfort, KY)
- …to appropriate multi-disciplinary resources. In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an ... performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members… more
- Molina Healthcare (Lexington, KY)
- **Job Description** We are looking for a Case Manager (licensure required LCSW, LPCC, and LMFT) who must reside in Kentucky. Will work telephonically supporting SMI ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Sharecare (Frankfort, KY)
- …2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program ... in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- Molina Healthcare (Lexington, KY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
- Public Consulting Group (Frankfort, KY)
- …complete accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes + Assesses and ... informed decisions by acting as their advocate regarding their clinical status and treatment options + Develops effective working...management, including as a nurse, medical, mental health care manager or a related job + Excellent knowledge of… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- Summary This position provides high- quality case management, clinical treatment, advocacy, and coordination of linkages to other appropriate VA or community ... in committee assignments, as deemed necessary by the service manager . Maintain data and statistical compilations to comply with...at least two years of experience post advanced practice clinical licensure and should be in a specialized area… more
- Highmark Health (Frankfort, KY)
- …performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a… more
- CenterWell (Frankfort, KY)
- … and operational area and/or related roles + Exposure or experience with clinical care delivery and interventions and/or care management + Experience leading ... safe, reliable pharmacy services and is committed to excellence and quality . Through our home delivery and over-the-counter fulfillment services, specialty, and… more