- CVS Health (Frankfort, KY)
- …Quality of Care: -Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Master's degree in Behavioral /Mental Health or related field** -Unencumbered Independent Behavioral Health clinical license in the state where they work:… more
- CVS Health (Frankfort, KY)
- …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
- CVS Health (Frankfort, KY)
- …Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations ... standard business hours. No weekends and no holidays.** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical… more
- CVS Health (Frankfort, KY)
- …of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Master's degree in Behavioral /Mental Health or related field. + Unencumbered Behavioral Health clinical license in Kentucky (LCSW, LPCC, LMFT) **Anticipated… more
- Highmark Health (Frankfort, KY)
- …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
- 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 ... may impact member outcomes and care planning components with appropriate engagement of clinical case management or crisis intervention as appropriate. - +… more
- CVS Health (Frankfort, KY)
- …we do it all with heart, each and every day. **Job Summary:** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, ... for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH)… more
- Humana (Frankfort, KY)
- …the Director, Case Management and supports the strategic priorities for Clinical Operations, Medical & Behavioral Health and Humana Government Business ... Puerto Rico. + Current valid and unrestricted Registered Nurse license + Certified Case Manager (CCM) + 5 years of healthcare supervisory/management experience,… 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
- Highmark Health (Frankfort, KY)
- …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