- Public Consulting Group (Frankfort, KY)
- …www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible ... publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers… more
- CVS Health (Frankfort, 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 ... member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - + Coordinates and… more
- CVS Health (Frankfort, KY)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
- Otsuka America Pharmaceutical Inc. (Frankfort, KY)
- The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to execute against a ... field + Background in advocacy, counseling, nursing, or social work + Case management experience in the specific therapy area + Bilingual skills, particularly… more
- Public Consulting Group (Frankfort, KY)
- …that is safe, timely, effective, efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine ... to conduct periodic in person assessments + Facilitates multiple care aspects ( case coordination, information sharing, etc.) + Helps patients make informed decisions… more
- Highmark Health (Frankfort, KY)
- …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior… more
- CVS Health (Frankfort, KY)
- …comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan ... and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while… more
- Cardinal Health (Frankfort, KY)
- …+ Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience + ... Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services + Assist in obtaining… more
- Cardinal Health (Frankfort, KY)
- …+ Must demonstrate a superior willingness to help external and internal customers + First point of contact on inbound calls, and determines needs, and handles ... Cardinal Health Sonexus (TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma,… more
- Travelers Insurance Company (Frankfort, KY)
- …with insured based on application of policy information to facts or allegations of each case . + Work with Manager on use of Claim Coverage Counsel as needed. ... statements, as strategically appropriate. + Complete outside investigation as needed per case specifics. + Travels frequently inclusive of claim office visits, court… more
- Humana (Frankfort, KY)
- …presentations to senior leaders **Preferred Qualifications** + Bachelor's degree + Certified Case Manager + Registered Nurse + Licensed Social Worker ... **Additional Information** **Work at Home Internet Statement** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum,… more
- Cardinal Health (Frankfort, KY)
- …helps manufacturers rethink how far their products can go. **Accountabilities** The Case Manager supports patient access to therapy through Reimbursement Support ... Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating… more
- Sumitomo Pharma (Frankfort, KY)
- …highly motivated, and experienced individual for the position of **Associate Manager , Compliance, Training & Strategic Alliance (CTSA), PVRM** . The Associate ... Manager , Compliance, Training & Strategic Alliance (CTSA), PVRM is...compliance issues and significant quality issues originating with the case processing vendor and License Partner. + Participate in… more
- Datavant (Frankfort, KY)
- …vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the Business Analytics team and ... of its analysts. We are looking for a hands-on manager who has experience and interest in providing guidance...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Datavant (Frankfort, KY)
- …in healthcare. **Role Summary:** We're looking for a Staff Product Marketing Manager who thrives at the intersection of product, customer, and commercial strategy. ... and proof points of our products. Each Product Marketing Manager is responsible for being a product and market...for the product lines in your vertical (in this case , the Provider product vertical). That requires you to… 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
- Datavant (Frankfort, KY)
- …realize our bold vision for healthcare. We are looking for a Health Information Operations Manager that will be the tip of the spear for our service offering. Our ... outcomes. **You will:** + Serve as the primary Account Manager to our customers + Mentor and develop hourly...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Datavant (Frankfort, KY)
- …vision for healthcare. **What We're Looking For** We are seeking a **Senior Manager of Enterprise Architecture** to lead a small team of architects responsible for ... oversee architectural responsibilities for their zone . The Senior Manager will play a critical role in aligning decentralized...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Datavant (Frankfort, KY)
- …healthcare. Datavant is seeking a detail-oriented and proactive **Marketing Operations Manager ** to support the operational backbone of our enterprise marketing ... requirements will be reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in which you will be working, exemptions… more
- Datavant (Frankfort, KY)
- …for healthcare. **Role Summary:** We are seeking a strategic and detail-oriented Compensation Manager to join our Total Rewards team. Reporting to the Head of Total ... requirements will be reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in which you will be working, exemptions… more