- 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
- 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 (Lexington, 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
- Molina Healthcare (Lexington, 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
- 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 (Lexington, 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
- 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
- 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
- Molina Healthcare (Lexington, 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