- CVS Health (Madison, WI)
- …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
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing ... case management throughout the continuum of care. The case manager will offer guidance. support, and...each beneficiary's capacity for self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care.… more
- Highmark Health (Madison, WI)
- …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
- Meriter-UnityPoint Health (Madison, WI)
- …backgrounds and their effected family members. This position is the primary case manager for patients receiving Addiction Medicine services. When applicable, ... completing training in Motivational Interviewing, Dialectical Behavior Therapy, or Cognitive Behavioral Therapy. $7,500 SIGN ON BONUS! Why UnityPoint Health? +… more
- UnityPoint Health (Madison, WI)
- …backgrounds and their effected family members. This position is the primary case manager for patients receiving Addiction Medicine services. When applicable, ... Week: 40 Weekends: No Benefit Eligible The Addictions and Behavioral Health Therapist and Clinical Supervisor applies...as on-site designee in charge in absence of clinic manager . As part of our commitment to continuous professional… more
- Molina Healthcare (Madison, WI)
- …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
- Molina Healthcare (Madison, WI)
- …**KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... management, disease management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical auditing/review… more
- Molina Healthcare (Madison, WI)
- …services. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active and unrestricted Certified Case Manager (CCM) Active, unrestricted State Nursing license ... 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 (Portage, WI)
- …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 (Madison, WI)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... 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
- CenterWell (Madison, WI)
- …Medicare/Medicaid experience a plus + Previous experience in utilization management, case management, discharge planning and/or home health or rehab + Certification ... in Case Management a plus (CCM) + Experience working with...go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients'… more
- CenterWell (Madison, WI)
- …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 (Madison, WI)
- …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