- Humana (Springfield, IL)
- …licenses)** + Minimum of 2 years of post-degree clinical experience in behavioral health setting + Case management experience working with complex SMI, SUD, ... and help us put health first** Job Description Summary The Field Care Manager , Behavioral Health performs primarily face to face and telephonic assessments… more
- Humana (Springfield, IL)
- …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 (Springfield, IL)
- …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
- CVS Health (Springfield, IL)
- …and problem-solving skills. **Preferred Qualifications:** + BSN degree. + Certified Case Manager (CCM) credential. + Experience working with dual-eligible ... within reasonable proximity to ensure timely access to members for in-person case management activities. Travel within the assigned territory is required to conduct… more
- Humana (Springfield, IL)
- …Qualifications** + Advanced degree in nursing or business health field. + Certified Case Manager (CCM). + Previous experience working in a managed care ... behavioral health professionals responsible for care management. The Manager , Care Management, works within specific guidelines and procedures; applies advanced… more
- Centene Corporation (Springfield, IL)
- …95% OF THE OUTREACH WILL BE TELEPHONIC OR ON CAMERA , WITH HOME VISITS ON A CASE BY CASE BASIS AS REQUIRED BY ACQUITY. MILEAGE WILL BE REIMBURSED ROUND TRIP AT ... and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare… more
- Molina Healthcare (Carlinville, IL)
- …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 (Springfield, IL)
- …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 (Springfield, IL)
- …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 (Springfield, IL)
- …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 (Springfield, IL)
- …Preferred Qualifications * Transitions of care sub-specialty certification and/or Certified Case Manager (CCM). * Hospital discharge planning or home ... services, and advance directives. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.… more