- CVS Health (Springfield, IL)
- …meetings and/or trainings in Downers Grove IL as needed/requested by Management.** BH Clinical Case Manager is responsible for telephonically and/or face ... Care: - Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies,...direct clinical practice experience post masters in Behavioral Health * Minimum 1+ year of Case… more
- CVS Health (Springfield, IL)
- …can be anywhere within 8am -8pm as needed to meet business needs. The Care Manager BH coordinates all case management activities with members to evaluate medical ... Instructs programs and procedures in compliance with network management and clinical coverage policies. Essential Duties and Responsibilities: + Executes evaluation… more
- 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
- 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
- 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
- CVS Health (Springfield, IL)
- …and problem-solving skills. **Preferred Qualifications:** + BSN degree. + Certified Case Manager (CCM) credential. + Experience working with dual-eligible ... Southern Cook County** to ensure timely access to members for in-person case management activities. Travel throughout the assigned territory is required to conduct… more
- Molina Healthcare (Mason City, 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