- Fallon Health (Worcester, MA)
- …for member experience and service and clinical quality. **Brief Summary of Purpose:** The Behavioral Health Case Manager (BHCM) is responsible for assessing ... with a special focus on those who qualify for Medicare and Medicaid. We also serve as a provider...member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case… more
- Fallon Health (Milford, MA)
- …approves their care plan o Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric ... we strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE...or her health needs, social needs or behavioral health needs o Collaborates with appropriate… more
- CenterWell (Providence, RI)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health , Accountable Care Organizations (ACOs), medical… more
- Highmark Health (Providence, RI)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs… more
- Molina Healthcare (Worcester, MA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... multidisciplinary integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports for Molina… more