- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job has primary ownership and oversight over a specified panel of members that range in ... health status/severity and clinical needs. The incumbent assesses ...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- HCA Healthcare (Nashville, TN)
- …Medical Center we support our colleagues in their positions. Join our Team as a(an) Case Manager RN and access programs to assist with every stage of your ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...gain certifications and job skills. Apply today for our Case Manager RN opening and continue to… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the PRN career opportunities as a(an) Case Manager RN PRN you want with your current employer? We have an exciting ... for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine...of colleagues. Do you want to work as a(an) Case Manager RN PRN where your passion… more
- HCA Healthcare (Nashville, TN)
- …services 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 ... Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...Eligibility for benefits may vary by location. The RN Case Manager is responsible for promoting patient-centered… more
- HCA Healthcare (Hermitage, TN)
- …nurses set us apart from any other healthcare provider. We are seeking a(an) Case Manager RN to join our healthcare family. **Benefits** TriStar Summit Medical ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...their passion for patient care. Apply today for our Case Manager RN opportunity. **Job Summary and… more
- Maxim Healthcare Services (Brentwood, TN)
- Maxim Healthcare Services in Nashville is hiring for a Case Manager to oversee the clinical care of homecare clients Why This Role? + Balanced Responsibilities + ... team where your expertise and dedication are truly valued. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company… more
- Highmark Health (Nashville, TN)
- …appropriate resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** HNAS ( Health Now Administrative Services) offers flexible, cost-effective solutions for employee ... health benefits. HNAS is part of Highmark Health...or its strategic business partners. When this is the case , there may be less direct reporting relationships and… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- …in caring for medically fragile children with complex medical and/or behavioral health needs\. The Nurse Care Manager will assess for child development and ... Community is required _Skills\\Certifications_ + Currently has a Certified Case Manager \(CCM\) credential or must obtain...as, coordinate additional Medicaid benefits to include medical and behavioral health services which may not be… more
- Highmark Health (Nashville, TN)
- …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... the engagement deliverables, resources, and outcomes. + Develop the engagement business case , scope, staffing and incentive model for RPM engagement with Providers… more
- HCA Healthcare (Nashville, TN)
- …services 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 ... an organization that invests in you as a(an) Sr Manager ? At Work from Home, you come first. HCA...HCA offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Nashville, TN)
- …services 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 ... is incentive eligible. **Job Summary and Qualifications** The Regional Coding Operations Manager is responsible for assisting in the development and evolution of the… more
- HCA Healthcare (Nashville, TN)
- …services 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 ... join an organization that invests in you as a Manager Physician Advisor Coordination? At Parallon, you come first....Parallon, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Highmark Health (Nashville, TN)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Elevance Health (Nashville, TN)
- …care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational ... or clinical assessments to identify individual member knowledge, skills and behavioral needs. + Identifies and/or coordinates specific health coaching plan… more
- Elevance Health (Nashville, TN)
- …The **Medicare Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- HCA Healthcare (Nashville, TN)
- …services 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 ... have the career opportunities as a(an) PRN RN Home Health you want in your current role? We invest...physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** +… more
- HCA Healthcare (Nashville, TN)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical ... you have the PRN career opportunities as a Home Health PRN RN you want with your current employer?...physician's orders and under the supervision of the Clinical Manager . What you will do in this role: +… more
- Elevance Health (Nashville, TN)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer consultation… more
- Highmark Health (Nashville, TN)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more