- Humana (Frankfort, KY)
- …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 (Frankfort, KY)
- …it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in ... to facilitate and support the member's improved health. The Case Manager develops a proactive course of...policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that… more
- Molina Healthcare (Lexington, KY)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... to provide quality and cost-effective member care. Essential Job Duties * Provides behavioral health oversight and clinical leadership for health plan and/or… 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
- Molina Healthcare (Lexington, KY)
- …to navigate online portals and databases. **Preferred Qualifications** + Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
- Molina Healthcare (Lexington, KY)
- …program(s) proficiency. Preferred Qualifications **LVN is preferred for this role.** * Certified Case Manager (CCM). To all current Molina employees: If you are ... integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-related education and services… more
- Molina Healthcare (Lexington, KY)
- …to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), ... Required Qualifications * At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the… more
- Highmark Health (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Lexington, KY)
- …Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) Work schedule :M - F Pacific ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- HCA Healthcare (Frankfort, KY)
- …to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Frankfort Regional Medical ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...and special projects as assigned by the RN, Nurse Manager or Director. What qualifications you will need: +… more