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Molina Healthcare
Overview
The role involves providing support for care management and care coordination for long-term services and supports, collaborating with a multidisciplinary team to ensure integrated delivery of care across the continuum for high-need members. Essential duties include completing comprehensive member assessments via in-person home visits, facilitating waiver enrollment, developing and implementing care plans, and monitoring their effectiveness to achieve desired member outcomes.
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Compensation
Salary not listed
Posted
7 days ago
Charis Hearts Inc
Provide non-medical in-home and community care based on Client Service Plans, including wellness checks and assistance with activities of daily living. Ensure strict compliance with agency policies, maintain client confidentiality, and accurately submit all required documentation.
$16 / HOUR
9 days ago
Elevance Health
Provide primary and acute care via telephone and video to patients in home and community-based settings. Collaborate with physicians and families to develop and implement complex clinical plans of care for adult patients with chronic conditions.
11 days ago
Provide non-medical in-home and community care based on client service plans, including wellness checks and assistance with daily living activities. Maintain accurate documentation and ensure strict confidentiality and safety reporting for all service recipients.
13 days ago
Sentara Health
The Clinical Pharmacist works with members to close medication-related gaps in care and provides counseling on medication therapy. They are responsible for managing referrals and educating members to improve health outcomes.
14 days ago
Provide non-medical in-home and community care based on Client Service Plans, including wellness checks and assistance with activities of daily living. Ensure strict compliance with agency policies, maintain confidential records, and report any incidents or abuse immediately.
Provide non-medical in-home and community care based on Client Service Plans, including wellness checks and assistance with activities of daily living. Ensure strict compliance with agency policies, maintain client confidentiality, and accurately submit required documentation.
Provide non-medical in-home and community care based on Client Service Plans, including wellness checks and assistance with activities of daily living. Ensure strict compliance with agency policies, maintain confidential records, and report any incidents or suspected abuse immediately.
15 days ago
Acadia
The specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. They are responsible for conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
22 days ago
The Utilization Specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
23 days ago
Collaborate with physicians and families to develop and implement complex clinical plans of care for adult patients with chronic conditions via telehealth. Provide primary and urgent healthcare, educate patients on medication and nutrition, and coordinate resources with inter-disciplinary teams.
$115,184 - $198,144 / YEAR
24 days ago
The role involves monitoring patient service utilization to optimize facility reimbursement and acting as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
The specialist monitors patient service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
25 days ago
The specialist monitors the utilization of services to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
$31 - $50 / HOUR
The specialist monitors service utilization to optimize facility reimbursement and acts as a liaison between managed care organizations and clinical staff. Key duties include conducting medical necessity reviews, managing the appeal process for denied stays, and providing staff training on documentation requirements.
Coordinate care for medically and behaviorally complex members, including children, adolescents, and adults. Manage cases within residential facilities in Central Virginia to improve overall health outcomes.
28 days ago
TRILLIUM HEALTH RESOURCES
Provide complex care coordination and monitoring for members with primary Intellectual or Developmental Disabilities. Utilize person-centered planning and multi-disciplinary collaboration to ensure quality support and adherence to waiver requirements.
$54,106 - $67,210 / YEAR
Develops and monitors care plans for low and high-risk pregnant populations through telephonic and face-to-face assessments. Coordinates care with multidisciplinary teams to optimize member health and ensure efficient utilization of health benefits.
29 days ago
