- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical ... health and behavioral healthcare through assessment and care planning, direct provider...or Company. **Required qualifications:** + 3 years of direct clinical practice experience post master's degree + Requires knowledge… more
- Molina Healthcare (Louisville, KY)
- …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... per regulated timelines and determines who may qualify for case management based on clinical judgment, changes...Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education… more
- Molina Healthcare (Louisville, 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
- Elevance Health (Louisville, KY)
- …for clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers ... ** Behavioral Health Medical** **Director-Psychiatrist** **Appeals** **Location:** This role...manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews.… more
- Molina Healthcare (Louisville, KY)
- …Nurse who lives in Kentucky and must be licensed for the state of Kentucky Case Manager RN will work with KY Medicaid population providing telephonic case ... health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- Molina Healthcare (Louisville, KY)
- …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
- Molina Healthcare (Louisville, 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