Community Behavioral Health Manager Jobs

Become a part of our caring community Humana/iCare is seeking an RN Care Manager to join the team in the Family Care Partnership (FCP) program to provide services to members in our newly expanded service area to include the following Counties: Racine, Kenosha, Waukesha, Washington, Ozaukee, Walworth and Sheboygan. Reporting to the Manager of Care Management, you will provide case management and support to adults in the community, assuring quality services are provided that are cost effective, all while monitoring the health and safety of your members. You will work as part of an Interdisciplinary Team (IDT) setting to help manage members that are enrolled in the Family Care Partnership program. You will conduct home and community visits to members to complete the nursing assessment and assures members have appropriate care and access to services. Essential duties: Complete the nursing portion of the comprehensive assessment and provide input to the members care accordingly. Monitor wellness and health promotion activities based on the member's assessment and identified outcomes. Re-evaluate the member's health and wellness at appropriate intervals to manage ongoing health issues, assess the member's response to interventions, or when a medical complaint or event affecting the member's health occurs. Perform routine health monitoring activities, based on the member's need. Build constructive working relationships with members, their family members, and appropriate outside agency staff. In crisis situations, provides appropriate assessment of psychiatric, behavioral or medical problems and implements interventions in conjunction with other staff to take appropriate measures to ensure the safety of members. Evaluate members' ability to safely manage, either by themselves or through use of

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time, remote, telehealth role. Must live in a compact state and hold a compact license in MT or PST zones. Working schedule is Monday-Friday, standard business hours in time zone of residence with one to two days per week until 7 PM MT or PST. This is an exciting team to join because we specialize in engaging and advocating for disengaged, vulnerable members who often have multiple medical, behavioral, and social challenges. We’re uniquely positioned to meaningfully improve health outcomes and costs. As Case Manager RN, you will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and facilitate the member’s overall wellness. You will develop a proactive course of action to address the issues presented to enhance their short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. You will also: Use clinical tools and information/data review to conduct an evaluation of members’ needs and benefits. Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning. Conduct assessmen

Become a part of our caring community The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Current valid social service license, e.g. LMSW, LCSW, LPC, LMHC Master's degree in a behavioral-health field, such as social work, counseling, or related health discipline from an accredited university 2+ years or more of experience working as a behavioral health professional Experience with behavioral change, health promotion, and coaching Proficiency with Microsoft Office Programs, e.g. Word, Excel & PowerPoint, shared systems, troubleshoot and resolve general technical is

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Behavioral Health Utilization Management Clinician Remote | Louisiana Preferred | Monday-Friday/Tuesday-Saturday Schedule Are you a licensed Behavioral Health professional or Psychiatric RN looking to make a meaningful impact on members' mental health outcomes? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, evidence-based behavioral health services while supporting quality care and effective treatment planning. What You'll Do Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care Apply evidence-based guidelines and clinical best practices across multiple levels of care Coordinate and communicate utilization management decisions with providers and care teams Provide triage support and crisis intervention as needed Facilitate effective discharge planning and transitions of care Identify members at risk for poor outcomes and coordinate referrals to additional programs and services Promote quality, cost-effective healthcare utilization and positive member outcomes Collaborate with internal and external stakeholders to support comprehensive care management WHAT YOU BRING – REQUIRED Active, unrestricted ind

Become a part of our caring community The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Reports to the Regional CM Manager. Use your skills to make an impact Required Qualifications Must have an active, unrestricted SC Licensed Masters Social Worker (LMSW), Licensed Professional Counselor (LPC) OR an active, unrestricted compact Registered Nurse (RN) license . 2 or more years of experience working as a behavior

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS code assignments Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices Manages multiple priorities, collaborates with peers and ensures timely completion of outpatient coding disputes Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Behavioral Health Specialist - Columbus GA - Requires LCSW, LPC or LMFT Company: Oak Street Health - Columbus, GA Role Description: The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. The Behavioral Health Specialist will assess the needs of patients, make referrals to appropriate behavioral health resources and specialists, and provide short-term counseling and evidence-based treatments as indicated. This role has the potential option for remote work days based upon achievement and maintenance of program metrics. Core Responsibilities: Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program Screen and assess patients for common mental health and substance use disorders Develop care plans and provide or facilitate referrals to Oak Street’s psychiatric consultant and/or external resources Pr

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Behavioral Health Specialist - Requires LISW, LPCC or LMFT Company: Oak Street Health Role Description: The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. The Behavioral Health Specialist will assess the needs of patients, make referrals to appropriate behavioral health resources and specialists, and provide short-term counseling and evidence-based treatments as indicated. This role has the potential option for remote work days based upon achievement and maintenance of program metrics. Core Responsibilities: Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program Screen and assess patients for common mental health and substance use disorders Develop care plans and provide or facilitate referrals to Oak Street’s psychiatric consultant and/or external resources Provide short-term counseling and evidence-based treatm

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Behavioral Health Specialist - Requires LCSW, LCPC or LMFT - Bilingual Spanish Required Company: Oak Street Health Role Description: The purpose of a Behavioral Health Specialist at Oak Street Health is to provide care management services and to provide evidence-based short-term psychotherapy to our patients with behavioral health needs. The Behavioral Health Specialist is a key resource for Care Teams across a region of Oak Street Health primary clinics. They are responsible for coordinating and supporting behavioral healthcare for our patients, in collaboration with Care Teams and a psychiatric consultant. The Behavioral Health Specialist will assess the needs of patients, make referrals to appropriate behavioral health resources and specialists, and provide short-term counseling and evidence-based treatments as indicated. This role has the potential option for remote work days based upon achievement and maintenance of program metrics. Core Responsibilities: Collaborate with the primary care teams to identify appropriate patients to refer to the Oak Street Behavioral Health Program Screen and assess patients for common mental health and substance use disorders Develop care plans and provide or facilitate referrals to Oak Street’s psychiatric consultant and/or external resources Provide s

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Must reside in Louisiana for this role. The Behavioral Health PTA serves as the primary provider-facing resource responsible for partnering with behavioral health providers, community mental health centers, health systems, and integrated delivery organizations to improve quality performance and adoption of best practices. In addition to traditional practice transformation responsibilities, this role supports the expansion of behavioral health data exchange capabilities, including increased utilization of ADT feeds, clinical data sharing, supplemental data acquisition, and improved reporting workflows that enable more timely member intervention and performance monitoring. Strategic Value The position will: Drive improvement in behavioral health quality measures. Support provider adoption of evidence-based behavioral health workflows. Strengthen provider accountability for quality performance. Improve transition-of-care management between inpatient, ED, and o

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time field-based and telework position, in Ohio. This position requires the ability to travel within the assigned region of Ohio to member homes and other requested member locations, up to 50% or more of the time. Applicants must reside in central or southeastern Ohio. Preferred counties: Ashland, Athens, Coshocton, Delaware, Fairfield, Fayette, Franklin, Gallia, Guernsey, Highland, Hocking, Holmes, Jackson, Knox, Licking, Meigs, Morgan, Morrow, Muskingum, Noble, Perry, Pickaway, Pike, Richland, Ross, Vinton, Washington and Wayne. Monday-Friday 8-5pm with flexibility needed to work later to meet member needs. Business Overview As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time field-based telework position, in Ohio. This position requires the ability to travel within the assigned region of Western Ohio to member homes and other requested member locations, up to 50% or more of the time. Monday-Friday 8-5pm with flexibility needed to work later to meet member needs. Business Overview As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Must reside in Ohio. Fundamental Components: • Be clinically and culturally competent/responsive with training and experience necessary to manage complex cases in the co

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time field-based telework position, in Ohio. This position requires the ability to travel within the assigned region of Northeast Ohio to member homes and other requested member locations, up to 50% or more of the time. Applicants may reside within the Northeast care coordination region of Ohio. Strongly prefers candidates to reside in one of the following counties: Marion, Crawford, Sandusky, Summit, Medina, Lorain, Portage, Geauga, Lake, Ashtabula, Stark, Belmont, Tuscarawas, or Harrison Counties Monday-Friday 8-5pm with flexibility needed to work later to meet member needs. Business Overview As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes fo

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time field-based telework position, in Ohio. This position requires the ability to travel within the assigned region of Central and Southeast Ohio to member homes and other requested member locations, up to 50% or more of the time. Applicants may reside within the Central/SE care coordination region of Ohio. Strongly prefers candidates to reside in one of the following counties: Fairfield, Franklin, Licking, Muskingum, Perry, Pickaway, Hocking, Fayette, Ross, Richland, Highland, Franklin Monday-Friday 8-5pm with flexibility needed to work later to meet member needs. Business Overview As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes fo

Become a part of our caring community The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. You will report to the Manager, Care Management of Behavioral Health. The Field Care Manager Nurse 2 employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. In this role, you will travel up to 50% of the time to support collaboration, conduct face-to-face meetings, and engage directly with staff, providers, members, and their families. Note: travel requirements have shifted and you will only need to travel up to 50%. Also, one of the questions within the application relate to travel and can't be adjusted to reflect the change. NOTE: You should reside in the Midlands OR Upstate area where your region will be. Use your skills to make an impact Required Qualifications Bachelor's in nursing (BSN) and have an active license in the state of South Carolina without disciplinary action. Must reside in the State of South Carolina 2 or more years of experience of case/care management 2 or more years working with the behavioral hea