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Centene Corporation
- Council Bluffs, IA / Sioux City, IA / Iowa City, IA / 1 more...
Provider Relations Specialist I Provider Relations Specialist I (009OB) Conduct regular meetings with the providers documenting discussions, issues, attendees, and action items. Research claims issues and forward with appropriate documentation to relevant functional areas for resolution. Review claim reports for potential issues/concerns. Document trends, make recommendations for process improveme
Posted 10 days ago
Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management
Posted 25 days ago
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosi
Posted 30 days ago
Centene Corporation
- Davenport, IA / Des Moines, IA
Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management
Posted 2 months ago
Centene Corporation
- Cedar Rapids, IA / Creston, IA / Ottumwa, IA / 10 more...
Utilization Manager (Outpatient) Behavioral Health Utilization Manager (Outpatient) Behavioral Health (009M0) Position Purpose Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality
Posted 2 months ago
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Education/Experience Graduate from anAccredited School of Nursing. Bachelor's degree in Nursing preferred. 2 yearsof clinical nursing experience in a clinical, acute care, or community setting.Knowledge
Posted 3 months ago
Program Specialist I Social Work Program Specialist I Social Work (009KC) Identifyspecial needs members through the completion of health screens and otherresources Work with community outreach/member advocates tocoordinate member care Educate providers and community resources onprogram components and available support services Educate members with special needs to fostercompliance with program and
Posted 4 months ago
Program Specialist I Social Work Program Specialist I Social Work (009J9) Identifyspecial needs members through the completion of health screens and otherresources Work with community outreach/member advocates tocoordinate member care Educate providers and community resources onprogram components and available support services Educate members with special needs to fostercompliance with program and
Posted 4 months ago
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