Health unit supervisor jobs near me - 163 jobs

The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. This is a full-time, Monday - Friday, 8am-5pm position in your time zone. You'll enjoy the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Make outbound calls and receive inbound calls to assess members current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in state of residence Active Compact RN License or ability to obtain upon hire 3+ years of experience in a hospital, acute care or direct care setting Proven ability to type and have the ability to navigate a Windows based environment Have access to high-speed internet (DSL or Cable) Dedicated work area established that is separated from other living areas and provides information privacy Preferred Qualifications BSN Certified Case Manager (CCM) 1+ years of experience within Medical/Oncology Case management experience Experience or exposure to discharge planning Experience in a telephonic role Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license

This role works closely with Care Team Operations, Clinical Operations, Behavioral Health clinicians (LMFT/LCSW/LPCC), Community Health Workers (CHWs), Compliance, Finance (for authorizations), Care Operations Associates, and external partners including hospitals, primary care providers, behavioral health agencies, housing providers, and community-based organizations. Responsibilities Serve as the primary point of contact for assigned members with behavioral health and psychosocial complexity, building trust through consistent, trauma-informed engagement. Conduct comprehensive, holistic assessments addressing behavioral health, substance use, functional status, social determinants of health, safety risks, and care gaps. Develop, implement, and maintain person-centered care plans that integrate behavioral, medical, and social goals; update plans following transitions of care or changes in condition. Coordinate services across the continuum of care, including behavioral health providers, primary care, hospitals, housing supports, transportation, social services, and community-based organizations. Conduct required in-person home or community visits based on acuity, risk stratification, and payer requirements. Support Transitions of Care (TOCs) by completing timely follow-up, coordinating post-discharge services, and reinforcing discharge instructions and medication understanding. Utilize motivational interviewing, behavioral coaching, and health education to promote engagement, adherence, self-management, and long-term member stability. Identify, escalate, and address behavioral health risks, safety concerns, service delays, benefit lapses, and environmental barriers using HHN escalation protocols. Coordinate and track referrals, appointments, transportation, and follow-ups to ensure continuity and timeliness of care. Maintain accurate, timely, and audit-ready documentation of all assessments, encounters, and interventions in eClinicalWorks (ECW) and other HHN systems. Meet or exceed HHN and health plan productivity standards, including outreach cadence, encounter requirements, documentation timeliness, TOC completion, and quality measures. Actively participate in multidisciplinary case reviews, care conferences, team huddles, and escalations with nurses, behavioral health clinicians, CHWs, care operations, and compliance. Assist members with plan navigation, eligibility redeterminations, social service applications, housing resources, and crisis intervention support. Communicate professionally with members and care partners using HHN-approved channels, including phone, RingCentral, secure messaging, and SMS workflows. Contribute to continuous quality improvement efforts by identifying workflow gaps, documenting barriers, and sharing insights to improve care delivery. Uphold confidentiality and comply with all HIPAA, Medi-Cal, ECM, and payer regulatory requirements. Remain flexible and responsive to member needs, including field-based work and engagement in community settings. Skills Required Bilingual (English/Spanish) proficiency required to support member engagement and care coordination. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field. Licensure: Licensed LMFT, LCSW, LPCC.; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.

*Care Manager (Remote)* *Start Date : 2/17* *Work Environment:* * Fully remote; must have a quiet workspace and provide a photo of designated area. * Shift: 8:00 AM - 8:00 PM EST (8-hour shift) * Training: 8:30 AM - 5:00 PM EST for 2 weeks Care Managers make high-volume outbound calls to payors/pharmacy benefit managers (PBMs) to verify copay support eligibility for commercially insured patients. This is a phone-intensive role (up to 95% of shift on calls) requiring strict adherence to scripts, accurate documentation, and professional customer service. *Key Responsibilities:* * Make outbound calls to PBMs/payors for copay eligibility; maintain 95% phone engagement. * Follow approved call guides and compliant scripts. * Identify and record plan types (e.g., Traditional, Accumulator, Maximizer). * Use PBM-specific workflows to gather benefit details. * Document all interactions accurately in CRM/telephony tools in real time. * Manage follow-up tasks promptly. * Maintain proper telephony status and campaign selection. * Adhere to compliance, privacy, and quality standards. * Collaborate professionally with PBM contacts and internal teams. *Requirements:* * *Experience:* 1+ year in a call center or high-volume phone environment preferred. * *Skills:* Strong attention to detail, excellent verbal communication, ability to follow scripts and document accurately. * *Technical:* Reliable high-speed internet, computer with webcam, and ability to work in a quiet space (photo required). * *Availability:* Must commit to training schedule and assigned shift. *Job Type & Location* This is a Contract position based out of Houston, TX. *Pay and Benefits*The pay range for this position is $21.00 - $21.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type*This is a fully remote position. *Application Deadline*This position is anticipated to close on Jan 16, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. • Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. • Conducts telephonic, face-to-face or home visits as required. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member caseload for regular outreach and management. • Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. • Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Are you a dedicated and experienced Behavioral Health professional with a passion for helping individuals on their recovery journey? We're seeking a proactive and compassionate Behavioral Health Supervisor to help guide our treatment team. If you thrive in a dynamic healthcare environment, possess a deep understanding of addiction therapy, and are committed to providing quality care, you'll be instrumental in shaping the future of our therapeutic programs. Join us in making a meaningful impact on the lives of those seeking recovery. Apply now and be a key player in our mission to support individuals on their path to wellness! Responsibilities BEHAVIORAL HEALTH LEADERSHIP: Provide direct patient care alongside supervision for behavioral health staff. Offer expertise on best practices and guidelines. Evaluate treatment plans, documentation, and services. PERFORMANCE MANAGEMENT: Ensure teams meet performance measures in compliance. Prioritize the patient experience while maintaining compliance. TRAINING AND ONBOARDING: Oversee onboarding and training for new hires. Implement policies, workflows, and trainings. COLLABORATION AND COMMUNICATION: Participate in and occasionally lead meetings and in-services. Partner with Operations Director for proper care. Provide updates on recruitment progress and market insights. COMPLIANCE MANAGEMENT Adhere to and manage compliance for supervision activities. Embrace and promote a culture of compliance. KNOWLEDGE, SKILLS, AND ABILITIES Excellent communication skills. High empathy and compassion for patients. Competent in working with a diverse population. Team player and natural problem solver. Adaptable and agile in a dynamic environment. Technologically capable, MS Office familiarity preferred. Strong commitment to compliance and integrity. Emerging leadership capabilities and early project management potential. Qualifications EXPERIENCE Required 5+ years' experience in a related field. Preferred 1+ years' experience as a Therapist at BrightView, or relevant experience. Prior supervisions experience. EDUCATION Required Consistent with state-level regulation and requirements, at minimum a Master's Degree Preferred Master's Degree LICENSES AND CERTIFICATIONS REQUIRED Active licensure consistent with state-level regulatory requirements, at minimum independently licensed with supervision designation BRIGHTVIEW HEALTH BENEFITS AND PERKS: PTO (Paid Time Off) Immediately vested and eligible in 401k program with employer match. Company sponsored ongoing training and certification opportunities. Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance. Tuition Reimbursement after 1 year in related field We offer competitive compensation, comprehensive benefits, and a supportive work environment dedicated to your professional growth and development. Ready to shape our future by bringing in top talent? Apply now and be a key player in our success!

About the role The April Parker Foundation is seeking compassionate, detail-oriented Care Managers (Generalists) to deliver Enhanced Care Management (ECM) and Community Supports (CS) services to Medi-Cal members with complex medical, behavioral, and social needs. You'll work directly with individuals experiencing housing insecurity, chronic illness, or behavioral-health challenges helping them navigate care, access community resources, and achieve stability in health and housing. This is a field-based / remote role ideal for professionals who value flexibility and meaningful impact. What you'll do Conduct outreach, assessments, and individualized care plans for ECM and CS members. Coordinate medical, behavioral, and social-service supports-including housing navigation and tenancy services. Complete timely documentation and progress tracking in APF systems. Provide in-person, telephonic, and virtual encounters based on member needs. Collaborate with health plans, community partners, and APF multidisciplinary teams. Maintain strict confidentiality and compliance with Medi-Cal, DHCS, and ILS guidelines. Compensation Base Salary (Straight-Time Pay) Salary is based on your caseload and is calculated using a simple, transparent formula: Each member = 2 paid hours per member per month (PMPM), at $25.00/hour ($50 PMPM) Your monthly salary increases as your caseload increases. Incentive Pay (Additional Earnings) You earn $40 per member per month for delivery qualified, on top of your base salary. Bringing total compensation to $90 PMPM, equivalent to $45/hour Reimbursements & Stipends Mileage reimbursement at the IRS rate $50/month phone stipend Reimbursement for approved work-related expenses Schedule Work hours are flexible and self-directed, provided Care Managers meet service delivery requirements and member availability Qualifications Minimum 2 years of experience in case management, care coordination, or related field Knowledge of Medi-Cal CalAIM programs, community resources, and social determinants of health Excellent documentation, organization, and communication skills Valid California Driver's License, auto insurance, and reliable transportation Preferred: Bachelor's degree or CHW certification; CA licensure (LCSW, LMFT, LPCC, RN, etc.)

Salvo is looking for an experienced Nurse to support our chronic disease patients. In this role, you'll be a key contributor to the management and delivery of our care program, working closely with our patients, registered dietitians, and partner physicians to provide best-in-class care. You'll use your medical knowledge and product expertise to help our members navigate Salvo Health, assisting in medical and administrative tasks to keep the member moving through the program. Additionally, you'll help shape how we build and scale our product and process. Our ideal candidate is someone who enjoys the challenges of an early-stage start up, is eager to learn, process oriented, and has a patient-first mindset. What You Will do: Provide exceptional care, disease management and health education to patients Support goal setting for individual patients asynchronously to help them better manage their chronic conditions Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors Help clients understand their motivations and create behavior change plans Conduct regular outreach to patients, based on their needs and preferences, to support engagement and elicit behavior change Coordinate with other clinical team members to provide an exceptional patient experience Develop and maintain professional, support-oriented working relationships with patients and team members Create and distribute health education materials to individual members as necessary Work with a cross-functional product team to develop and constantly improve our in-app patient experience Qualifications: 2+ year of experience as Licensed Practical Nurse or any Nursing license 2+ years of experience in patient-facing or customer-facing roles Compact state license required, additional licensing may be needed Bilingual (spanish speaking) a plus Excellent customer relation skills, as well as written and verbal communication skills Knowledge of medical terminology and proficiency of general medical office procedures Familiarity with digital applications like Slack, Coda, Google Workspace, etc. Strong analytical and proactive problem solving skills Self-motivated, results-oriented and strategic thinker Personal passion for health and wellness topics Must be authorized to work in the United States Experience working in telehealth or healthcare startup environment preferred Bonus: Experience working in GI, weight management, and/or with anti-obesity medications such as GLP-1s Salvo is a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. Our patients are assigned a “whole patient” care team and have seven day a week access to app-based care, using Remote Patient Monitoring (“RPM”) to bill under the patient's insurance. This is a major step forward to go beyond episodic appointments to continuous care at home, and deliver interdisciplinary wraparound care in partnership with the patient's existing local doctor. Salvo is backed by leading health care investors from innovators like Livongo, Ro, Ginger, Forward, Brightline, Tia, and others. Salvo care draws on expertise from Board-certified specialty physicians, registered dietitians, nurses, psychologists, and therapists who have developed our evidence-based protocols, for a personalized, multi-month journey to better health. Salvo is the first to bring a scalable and tech-enabled, more integrative approach to these chronic conditions, going beyond treating only the symptoms in order to identify and address the root causes of chronic illness. Salvo offers a competitive salary and health benefits, a remote work environment, flexible time-off, a larger sense of mission, and professional development and entrepreneurial opportunities. Working alongside a bunch of super talented and friendly people, in a culture that likes to drive constant innovation, and marked by relentless curiosity and a sense of empathy. Salvo is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

We are a nationally recognized healthcare management organization with over 40 years of experience delivering innovative, high-quality clinical solutions. Our mission is to improve member health outcomes by identifying risk, promoting treatment compliance, and delivering personalized care. Position Summary The Director of Utilization Management & Case Management provides strategic and operational leadership for UM and LCM programs. This role is responsible for driving clinical excellence, regulatory compliance, process improvement, and team performance while partnering with senior leadership, clients, and sales to support continued growth. Key Responsibilities Lead and manage UM and LCM teams, fostering high performance and professional development Ensure compliance with URAC standards and applicable state regulations Drive process improvement, efficiency, and automation initiatives Serve as clinical and operational SME for business development and new product launches Collaborate cross-functionally with Sales, Client Services, Clinical, and IT teams Support client relationships, reporting reviews, and strategic planning Participate in sales presentations and client meetings as needed Qualifications Bachelor's degree in healthcare, business, or related field Clinical background with healthcare leadership experience Progressive management experience in healthcare operations Experience working with senior leadership and external clients Experience in utilization management and case management Experience with self-funded groups and InterQual criteria preferred Strong communication, analytical, and leadership skills Ability to travel as needed (approximately 10%) Compensation & Benefits Competitive salary based on experience Comprehensive benefits package including medical, dental, vision, 401(k), PTO, and more Join Our Team If you are a strategic, results-driven healthcare leader ready to make an impact, we invite you to apply.

Hello, how are you? Are you a LPN that is looking to improve the health of patients that have complex conditions? Do you live within a reasonable driving distance to St. Joseph, MO? Would you like to work from home and travel for the training/occasional meetings? If you answered yes to the above and have/are: Savvy with basic software/services such as email, word, excel, etc. Detail oriented to the point of annoying people because you pick up on things that others don't. Partial to helping people that are unappreciated, overlooked, and may not have any other types of support. A solid home/office environment that enables you to get the job done correctly whenever it needs to be done. Naturally competitive and want to win. YOU want to be the best and enjoy working with others who are the same. An active LPN license that is in good standing. ****1000 imaginary bonus points if you have long-term care, skilled nursing, assisted living, care management, or other experience working with patients who have chronic conditions.**** At SparroWell, we want to win by helping others get the best care possible. Our awesome team works with physicians, nurse practitioners, and other clinical team members that specialize in taking care of people with chronic illnesses. Our advanced care team also supports patients, families, as well as their caregivers to provide additional resources whenever needed. On any given day, our team is coordinating care, reviewing medications, auditing charts like a BOSS, collaborating with medical providers, and ultimately making a difference in the lives of patients we serve. We work from home but do occasionally meet in person for meetings and training on the latest requirements/guidelines. Go ahead, start the conversation by sending us your resume today. We will consider all applicants even though we prefer to work with nurses that have long-term care or post-acute experience. If you would like to learn more about our company, please visit us at **************************** Thank you for reviewing our opportunity and we look forward to hearing from you.

Who We Are Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity. The primary location for this role is remote, travel is expected to be up to 10%, and the expected schedule is Monday - Friday 8:00am - 05:00pm central. Independently licensed in TX or MO (LCSW, LPC, LMHC, or LMFT) required. What You'll Do As the Manager, Behavioral Health Longitudinal at Imagine Pediatrics you will manage a team of supervisors overseeing three roles: Behavioral Health Therapists, Behavioral Health Care Managers, and Care Team Assistants who work as an interdisciplinary team to serve a patient population experiencing severe mental illness (SMI). This role oversees a regional behavioral health care team and is responsible for team metrics and program outcomes. 90% of Manager, Behavioral Health, longitudinal role will be administrative inclusive of the following: Manage a team of regional cross functional care team members with the support of supervisors. Provide oversight to a team of supervisors including 1:1 support, quarterly feedback, and typical functions of people management Provide guidance to supervisors regarding performance management of indirect reports. Uphold team members responsible to Imagine specific policies, clinical programming requirements, and utilization targets. Partner with talent acquisition to carry out hiring plans, interviews, and onboard new team members. Assist with strategic planning for expansion into new markets for company growth. Analyze programmatic metrics and individual metrics in order to utilize staff appropriately. Hold the team accountable for working at the top of their license and utilizing team functions as efficiently as possible Identify areas for improvement within team processes, clinical care, and action on projects to make them more efficient. Serve as the Behavioral Health Longitudinal representative in leadership meetings to provide feedback, improve patient experience, and support the development of new programs and services. Acts as the liaison for behavioral health services to all stakeholders taking a lead role in process and performance improvement and the delivery of high-quality services Collaborate with clinical education team for implementation of new trainings in alignment with care team and organizational needs. Create a positive and inclusive culture of teamwork and accountability Assist behavioral health team with navigating new processes, policies, and procedures. 10% of Manager, Behavioral Health - longitudinal role will be clinical and include but are not limited to the following responsibilities. Consult with market leaders on behavioral health cases. Manage patient escalations as needed. Support service recovery calls. What You Bring & How You Qualify First and foremost, you're passionate and committed to creating the world our sickest children deserve. You want an active role in building a diverse and values-driven culture. Things change quickly in a startup environment; you accept that and are willing to pivot quickly on priorities. A qualified candidate will be empathetic, caring, organized, and has strong relationship-building skills. In this role, you will need: Master's degree in social work, Marriage and Family Therapy, Counseling, or related area Must be licensed to independently practice in TX or MO (LCSW, LPC, LMHC, LMFT), openness to cross-state licensure. 5 years of experience post independent licensure in a behavioral health setting. 3 years of experience in management/supervision of mental health providers (experience in remote/start-ups environments preferred). Experience working with children, adolescents, and their caregivers inclusive of external systems involved in a minor's care. Experience with chart auditing and training to improvement-oriented outcomes. Certification/Training in evidence-based modalities including but not limited to cognitive behavioral therapy and dialectical behavioral therapy preferred Experience working with high-risk behavioral health populations including but not limited to suicidal ideation, homicidal ideation, severe persistent mental illness (SPMI), children in the foster care system. Strong preference and comfortability conducting triage assessments and crisis interventions. Diligent regarding documentation standards and accustomed to using electronic medical records. Experience working with a diverse population or demographics. Telehealth experience Familiarity with technology, Microsoft suites, and documenting in electronic health records. Fully remote with 10% travel for training/education What We Offer (Benefits + Perks) The role offers a base salary range of $88,000 - $107,000 in addition to annual bonus incentive, competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary. We provide these additional benefits and perks: Competitive medical, dental, and vision insurance Healthcare and Dependent Care FSA; Company-funded HSA 401(k) with 4% match, vested 100% from day one Employer-paid short and long-term disability Life insurance at 1x annual salary 20 days PTO + 10 Company Holidays & 2 Floating Holidays Paid new parent leave Additional benefits to be detailed in offer What We Live By We're guided by our five core values: Our Values: Children First. We put the best interests of children above all. We know that the right decision is always the one that creates more safe days at home for the children we serve today and in the future. Earn Trust. We listen first, speak second. We build lasting relationships by creating shared understanding and consistently following through on our commitments. Innovate Today. We believe that small improvements lead to big impact. We stay curious by asking questions and leveraging new ideas to learn and scale. Embrace Humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to grow and understand how we can improve. One Team, Diverse Perspectives. We actively seek a range of viewpoints to achieve better outcomes. Even when we see things differently, we stay aligned on our shared mission and support one another to move forward - together. We Value Diversity, Equity, Inclusion and Belonging We believe that creating a world where every child with complex medical conditions gets the care and support, they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth. Be part of a team that makes a real difference. Enjoy the perfect balance of remote work and meaningful field visits in this flexible role. Central Illinois area residency required as you'll travel throughout the region (up to 200 miles/4 hours round trip) to provide personalized care for clients. This position offers professional autonomy while building valuable connections with patients across diverse healthcare settings throughout Central Illinois. Join our compassionate team and help make a positive difference in an injured person's life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will: * Demonstrate knowledge, skills, and competency in the application of case management standards of practice. * Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan. * Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational. * Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient. * Work with employers and physicians to modify job duties where practical to facilitate early return to work. * Evaluate and modify case goals based on injured/disabled person's improvement and treatment effectiveness. * Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively. * Complete other duties, such as attend injured worker's appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned. Qualifications * Education: Associates Degree or Bachelor's Degree in Nursing or related field. * Experience: 2+ years clinical practice preferred. Workers' compensation-related experience preferred. * Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills. * Certifications, Licenses, Registrations: * Active Registered Nurse (RN) license required. Must be in good standing. * URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC). * Travel: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography. * Internet: Must have reliable internet. Benefits We're committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $70,000 - $83,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics. The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Don't meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles. #LI-MC1 Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers' Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager

DEPARTMENT OF CHILD SAFETY The Arizona Department of Child Safety (DCS) is a social and human services agency whose mission is to successfully partner with families, caregivers, and the community to strengthen families, ensure safety, and achieve permanency for all Arizona's children through prevention, services, and support. Human Services Unit Supervisor Job Location: POST-PERNENANCY SUPPORTS (SUBSIDY) 1818 E Sky Harbor Circle North Phoenix, AZ Posting Details: Salary: $28.1875 HRLY/$58,630.00 Salary Grade: 19 Closing Date: January 17, 2026 Job Summary: The AZ Adoption Subsidy Program is a primary post-permanency support for adoptive parents who adopt a child with special needs from the foster care system. This position supervises case managers responsible for executing child-specific adoption subsidy agreements with parents, provides case management and supports for the adoptive parents, and reviews each case on an annual basis. Job Duties: Supervises case managers in the program. Assures that each agreement, prior to legal execution, meets all federal and state requirements for the program. Signs each agreement as authorized DCS agency designee Manages the workload for the program. Assigns and re-assigns cases according to the level of expertise of the case manager, the special needs of the child, and array of services needed for the child. Works with attorneys and providers to assure quality services and prompt agency payment for these services. Interprets federal and state policies for program to assist case management staff in maintaining compliance. Makes suggestions to the program administrator for improvements in the program, service deliver, and service array. Implements LEAN management principles for program staff, assures huddle board visual management is in place and utilized to its fullest. Other duties as assigned as related to the position. Knowledge, Skills & Abilities (KSAs): Knowledge of : LEAN management processes Adoption subsidy (assistance) Effective supervisory practices Ombudsman type practices for demanding clients Skills in: Written and verbal communications Caseload management Supervisory and leadership techniques Ability to: Make decisions without Program Administrator routine approval Work efficiently & effectively with peer supervisors and professional teams Periodically review caseloads and modify as necessary based on staff Interpret complex federal and state laws Selective Preference(s): Bachelor's Degree in related discipline or a minimum of three years experience in a child welfare or behavioral health position required. Supervisory experience preferred. Pre-Employment Requirements: Requires possession of and ability to retain a current, valid state-issued driver's license appropriate to the assignment. Employees who drive on state business are subject to driver's license record checks, must maintain acceptable driving records and must complete any required driver training (see Arizona Administrative Code R2-10-207.12.). Must be able to secure and maintain clearance from DCS Central Registry. If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements. All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits: The State of Arizona provides an excellent comprehensive benefits package including: Affordable medical, dental, life, and short-term disability insurance plans Top-ranked retirement and long-term disability plans 10 paid holidays per year Vacation time accrued at 4:00 hours bi-weekly for the first 3 years Sick time accrued at 3:42 hours bi-weekly Deferred compensation plan Wellness plans By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion. Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page Retirement: Positions in this classification participate in the Arizona State Retirement System (ASRS). Enrollment eligibility will become effective after 27 weeks of employment. Contact Us: Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting ************ or by email at *************. Requests should be made as early as possible to allow time to arrange the accommodation. Should you have any further questions regarding the interview process you can reach out to a member of our recruitment team at ************ or by email at ********************. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

Job Description TITLE: Director Case Management / Utilization Management / CDI Now is your chance to join a Forbes magazine top 100 hospital where career growth and opportunity await you. They are committed to building healthcare teams whose care exceeds the expectations of their patients and community and are looking for quality talent who share the same values. They're nestled in a beautiful rural setting but close enough to the big city to enjoy that too! If that sounds like the change you are looking for, please read on… What you'll be doing: •Responsible for developing, planning, evaluating, and coordinating comprehensive patient care across the continuum, to enhance quality patient care while simultaneously promoting cost-effective resource utilization. Provides director-level oversight of Inpatient and ED Case Management, Utilization Management and Clinical Documentation Integrity programs, ensuring alignment with organizational goals and regulatory requirements. Monitors patient care, including utilization, quality assurance, discharge planning, continuity of care, and case management activities, and ensures that these functions are integrated into overall hospital operations. Coordinate and monitors activities with appropriate members of the health care team to promote efficient use of hospital resources, facilitate timely discharges, prevent and control infections, promote quality patient care, and reduce risk and liability. Collaborates closely with coders and revenue cycle teams to optimize clinical documentation and support accurate coding, reimbursement, and compliance initiatives. •Responsible for identifying tracking mechanisms in order to evaluate and achieve optimal financial outcomes, to enhance quality patient care, and promote cost-effective resource utilization. •Uses data to drive decisions, plan, and implement performance improvement strategies for case management, utilization management, and clinical documentation integrity •Coordinates daily activities of the Case Management, UM, and CDI Department in order to promote quality patient care, efficient use of hospital resources, facilitate timely and adequate discharges, and reduce risk and liability. •Investigates and initiates follow-up on utilization denials, contract negotiations, and external regulatory agencies' requirements. •Directs operations of our Physician Advisor Program, including analysis of performance through reporting and committee involvement and oversight. •Actively serves on hospital committees and teams and facilitates opportunities for employees to do the same. •Develops, performs, and improves personal and departmental knowledge of computer software and reporting functions. •Organizes and oversees the maintenance of denial and appeal activity. Follows up with physicians and others when indicated. •Prepares or coordinates the preparation of periodic and special reports required by various agencies, insurance contracts, and for hospital committees. •Analyzes and trends data results in order to incorporate efforts and information results with existing systems to optimize the efficiency of operational systems through strategic quality leadership. •Facilitates growth and development of the case management program, utilization management ( including physician advisor program and clinical documentation integrity (CDI), in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities, as needed. •Develop new resources where gaps exist in the system as identified through research and data analysis to meet and enhance the quality/efficiency of comprehensive patient care and/or basic human needs for the community. •Interact with Corporate Consulting and Business office on issues such as contracting, billing, reimbursement, denials, and physician reports cards, and collaboratively initiate improvements related to these areas. •Maintains hospital compliance with the Quality Improvement Organization (QIO) and CMS guidelines. •Maintains professional knowledge by participating in educational seminars and opportunities. •Participates in Population Health work at an organizational level, including active involvement with the System-Wide Care Management Team and Value-Based Care Delivery. Additional info: •Position will report to a Manager that is well respected in the organization. Position is open as the person is retiring. They use EPIC(EMR) and the facility has a lot of technology. Person would be over about 50-60 people between CM/UM/CDI. Great team to work with. •If you're a passionate Pharmacist and seeking a rewarding career in a collaborative healthcare setting, this is the opportunity you've been waiting for. Join us in east central Ohio, and become part of our exceptional team dedicated to delivering high-quality care to our community. Apply now and embark on a fulfilling career journey with us. Requirements What they're looking for: •Master's degree in nursing, Healthcare Administration, or Business Administration required. •Current Ohio RN licensure (or active multi-state licensure). •Certified Case Manager(CSM). •At least three (3) years of management or demonstrated leadership experience required. •Knowledge of prospective payment systems, managed care, infection control surveillance, patient care, disease processes, discharge planning, and continuum of services offered within Genesis and externally. Knowledge of coding, mid-revenue cycle, CDI, physician advisor and payor relations. •Ability to perform data analysis and to utilize computer systems to record and communicate information to other services. •The ability to lead collaboration with other leaders in the organization, especially about the delivery of high-quality, timely, and right site of care. •Excellent leadership, verbal and organizational skills to order to steer the case management process. Benefits Hours and compensation potential: •The position is full time. •The range starts at $62.50hr($130K)-$75hr($156K) depends on years of experience. •Full benefits package being offered.

This position consists of weekly in-person Care Management visits with the client, coordination with PCP and telephonic contact to ensure adherence to treatment plan. Also must be available to answer questions that the client may have between visits. During the visit CM will gather information and educate the patient on his or her disease management, medication administration, and home safety in order to the client remain safely at home. CM will assist patient and/or family member to connect with other needed resources such as meals, transportation to PCP, and insuring that all prescribed medications are in the home. At all times the Director of Healthcare Operations is available as a resource to CM. Requirements Must have at least 1 year verifiable experience as a RN, LPN or Social Worker Must have an active professional license in your state. Must have a good driving record, auto insurance, a reliable vehicle Must have internet access for visit and assessment logging Must be a dependable person The applicant must not have Disciplinary Actions against their professional license or be listed in the List of Excluded Individuals/Entities Search Responsibilities The RN, LPN or Social Worker will also be required to enter all assessment and visit information into the online system within 24 hours of the visit. Upon hire and prior to the first visit, a short online training session and webinar will need to be completed. You will be required to visit the client once a week, 4 times a month on going. Flexible schedule. Work from home.

Do you dream of a role where you can connect with people and transform lives - all while working remotely? We're looking for Care Managers who thrive on building relationships with families with adult neurodivergent children - understanding their goals and helping them access specialized resources. Join us and transform the lives of hundreds of adults with developmental disabilities as you scale with a high-growth, innovative company. At NeuroNav, we believe everyone deserves the opportunity to make their own choices and shape their story, regardless of disability. Our mission is to enhance the quality of life for adults with developmental disabilities through simplicity and choice. We specialize in helping families navigate a specific California state funded program called Self-Determination, which offers more creative and custom choice as to how to leverage state funds. This is a life-changing program and you will be the conductor, breaking down barriers for your client and ensuring his or her success. As one of our virtual Care Managers (the heart and soul of our team called “Navigators” internally), you'll create custom client plans and guide families in a step-by-step process to enter and maintain participation in this program. In this remote role, you will be able to leverage your creativity, kindness and relational skills in social work, case management, and service coordination to transform your clients' lives and help them write the stories they dream of. About NeuroNav Founded at Stanford in 2020, with support from the Stanford Innovation Fellowship, Pear VC and Core Innovation Capital, NeuroNav drives new vision and change in disability by creating personalized care plans and connecting our neurodivergent clients with virtual Care Navigators who help manage their benefits. Last year, we supported hundreds of individuals in accessing life-changing services, and we're on track to quadruple our impact next year. Responsibilities include: Person-centered Planning - you will be trained in a special facilitation framework to capture your client's unique strengths, goals, needs and desired outcomes and align them to a plan unique to them. Budget & Spending Management - you will help translate personalized plans into concrete support needs and advocate for those needs to local budget authorities. Project Management - you will be the driver that holds the process together and guides the client and other partner organizations. Service Provider Access - you will leverage NeuroNav's proprietary resources to search for and assist providers in implementing person-centered plans throughout the year. Special Projects - you will contribute your talent and insights from working with clients into key company strategy and initiatives each quarter. What You'll Bring Bachelor's Degree or equivalent work experience Social Work or case management experience in the disability or social services field Client-facing experience managing multiple relationships at one time Excellent written and verbal communication skills Must have computer, reliable high-speed internet connection, and a quiet work environment Fluent in Spanish and bilingual (strongly preferred) Experience in a performance-based culture with metrics attainment goals (preferred) Experience serving in the developmental disability field (preferred) Experience with Microsoft Office & Google Suite (preferred) Experience in person-centered planning and in the California developmental disability system (preferred) Experience in Case management: 2 years (Preferred) Benefits We believe in supporting our employees' well-being and work-life balance as part of our culture and offer the following benefits: Remote first - Ability to work from home Health, vision and dental insurance 401(k) 14 Paid Time Off (PTO) days per year 7 sick or flex days per year Annual company retreat Salary: $50-60k per year (depending on experience)

JR167272 Manager Behavioral Health Services Responsible for overseeing Behavioral Health Utilization Management (BH UM), this position supports the Medicaid line of business. Location: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. How will you make an impact: * Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. * Ensures staff adheres to accreditation guidelines. * Supports quality improvement activities. * May assist with implementation of cost of care initiatives. * May attend meetings to review UM and/or CM process and discusses facility issues. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. * Responsibilities for BH UM may include: Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate interpretation/application of benefits, corporate medical policy and cost efficient, high quality care; manages consultation with facilities and providers to discuss plan benefits and alternative services; manages case consultation and education to customers and internal staff for efficient utilization of BH services; leads development and maintenance of positive relationship with providers and works to ensure quality outcomes and cost effective care; assists in developing clinical guidelines and medical policies used in performing medical necessity reviews; provides leadership in the development of new pilots and initiatives to improve care or lower cost of care. Minimum requirements: LICENSURE REQUIREMENTS FOR ALL FUNCTIONS: * Requires current, active, unrestricted license such as LCSW (as applicable by state law and scope of practice), LMHC, LPC, LMSW (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States. * For Government business only: LAPC, and LAMFT are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the manager's director has one of the types of licensures specified in the preceding sentence. * Licensure is a requirement for this position. EDUCATION/EXPERIENCE REQUIREMENTS: * Prior experience in Managed Care setting required. * Additional requirements for BH UM: MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and experience, which would provide an equivalent background. * Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. Preferred Skills, Capabilities, and Experiences: * Leadership and prior management experience. * Experience in managed care. * Candidates from all states are welcome, but they must reside within commuting distance of a Pulse Point office location where we have an office to be considered. * Proficiency in MS Office and data reporting. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

The Medical Case Manager is responsible for providing comprehensive case management services at Equitas Health and identifying and assisting HIV+ persons needing case management services throughout Ohio. The individual will operate in accordance with the established professional standards and guidelines as stated by the Ohio Revised Code and put forth by the Ohio Counselor, Social Work, and Marriage and Family Therapist Board. The individual will operate in accordance with the established professional standards and guidelines for the National Association of Social Workers (NASW) and agree to adhere to NASW standards for social work management. ESSENTIAL JOB FUNCTIONS: Essential functions of the job include, but are not limited to, traveling, driving, having reliable transportation to transport clients and meet clients, and utilizing a computer for typing and conducting research, attending meetings, conducting assessments, and counseling. MAJOR AREAS OF RESPONSIBILITY: Provide high-quality case management for clients and their families by assisting them to access medical services, health insurance, Ryan White benefits, and other resources and services to improve health outcomes, housing stability, and employment and income attainment. Conduct comprehensive psychosocial assessments for people with HIV/AIDS seeking services at intake and complete update assessments each bi-annually and as needed. Medical Case Managers will assist clients in completing and submitting all necessary documentation related to these assessments. Develop, monitor, and evaluate individual care plans for each assigned client at intake, bi-annually, and as needed thereafter. Case Plans will address services provided to the client within Equitas Health, as well as services managed within the community by other providers. Function as a central and primary access point for financial assistance programs, including but not limited to Ryan White Treatment Modernization Act (Part B and C), HOPWA short-term rental assistance, and other assistance programs as appropriate. Medical Case Managers will complete and submit paperwork as is needed to support clients in maintaining these assistance programs. Assess the client's mental health needs and provide crisis intervention as necessary. Medical Case Managers are responsible for completing lethality assessment documentation and consulting with Supervisors whenever a crisis occurs. Medical Case Managers will also reach out to community mental health services and consult with ongoing Mental Health and Therapy Providers as appropriate. Assist client with linkage to resources such as housing, respite, nutritional assistance, palliative care, chore assistance, transportation, and social functions that help increase the client's ability to remain independent in the community. Navigate community workforce programs and provide supportive services to clients that address the unique barriers to employment PLWHA may face in returning to work, understanding benefits eligibility, confidentiality, and health management in the workplace. Provide transportation to and from appointments related to resource needs, medical needs, and other activities related to the client's ability to remain independent within the community. Identify and engage health care professionals in the region to provide quality services to HIV+ individuals and establish new relationships in collaboration with ODH. Medical Case Managers will refer Providers who seek a relationship with ODH to the appropriate contacts within ODH. Represent Equitas Health within the community, engaging other service providers and providing education about special needs associated with a client living with HIV/AIDS in the primary care continuum, mental health continuum, and other community resources. Works collaboratively within a multidisciplinary team. Maintain confidentiality of clients by adhering to Equitas Health Confidentiality Policy and Procedure, HIPAA, and other established professional standards and guidelines. Medical Case Managers are responsible to maintain documentation through Equitas Health, ODH, and other software systems. All documentation will be recorded and complete within two business days of provided service. Effective written and verbal communication skills. Ensure that action items and updates are provided to Supervisor proactively. Capture feedback from clients, staff, and community partners and communicate the information to the appropriate persons. Returns client, provider, and other stakeholder correspondence within 2 business days. Achieve productivity standards maintained by Equitas Health, including spending no less than 60% per month of hours worked directly engaging with clients, their families, and other informal supports. Participate in and complete Peer Review Audits monthly. Medical Case Managers will maintain scores of no less than 90% on monthly peer reviews. Coordinate with clients in order to maintain Active status through Ryan White and other programs. Medical Case Managers are responsible to have no less than 90% of their clients within a date or identified as active in any given month. Responsible for accurate and timely completion of the documentation in order to provide accurate data and reports to Equitas Health and its Board, as well as federal, state, and local governments. Attend training, as assigned, to improve case management skills related to written and verbal skills, putting theory into practice, and accurate documentation across multiple systems. Medical Case Managers will participate in Motivational Interviewing training and Learning Groups. As appropriate, Supervisors will schedule shadowing and review recorded visits between Medical Case Managers and clients in order to evaluate Motivational Interviewing skills. Participate in Equitas Health Committees and Performance Improvement Teams as appropriate and assigned by direct supervisor. Prepare for and attend individual and group supervision per the Supervisor's schedule. Medical Case Managers are responsible for bringing client concerns, process questions, and other needs to scheduled supervisions. Medical Case Managers are required to attend 8 hours of supervision per month. Demonstrates unconditional positive regard to clients; Conducts all aspects of job responsibilities with a focus on exceptional customer service. Demonstrates continuous growth and development of Cultural Competency exhibiting an understanding, awareness, and respect for diversity. Attend monthly, quarterly, and as-needed meetings in-person at multiple agency sites and community partner locations. Utilize email, Skype, phone, and other telecommunication options to participate in meetings across sites. Other duties as assigned are related to this position by the supervisor. KNOWLEDGE, SKILLS, ABILITIES, AND OTHER QUALIFICATIONS: Minimum of BS/BSW and LSW required. Must have sensitivity to, interest in, and competence in cultural differences, HIV/AIDS, minority health, sexual practices, and a demonstrated competence in working with persons of color, and the gay/lesbian/bisexual/transgender community. Community-based Case Management and training experience desired. Proficiency in all Microsoft Office applications and other computer applications required. Reliable transportation, driver's license, and proof of auto insurance required. Knowledge and adherence to social work standards and ethics. OTHER INFORMATION: Background and reference checks will be conducted. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. In accordance with Equitas Health's Drug-Free Workplace Policy, pre-employment drug testing will be administered. EOE/AA It is the policy of Equitas Health that no employee or applicant will be discriminated against because of race, color, religion, creed, national origin, gender, gender identity and expression, sexual orientation, age, disability, HIV status, genetic information, political affiliation, marital status, union activity, military, veteran, and economic status, or any other characteristic protected in accordance with applicable federal, state, and local laws. This policy applies to all phases of its personnel activity including recruitment, hiring, placement, upgrading, training, promotion, transfer, separation, recall, compensation, benefits, education, recreation, and all other conditions or privileges of employment. Equitas Health values diversity and welcomes applicants from a broad array of backgrounds.

We are a rapidly growing healthcare organization dedicated to supporting patients living with chronic conditions. Our mission is to deliver personalized, high-quality care that empowers individuals to take control of their health with confidence. Through a fully remote model, our Care Managers guide patients through their care journeys-educating, advocating, and coordinating support that leads to better outcomes and smoother day-to-day management. We're looking for a motivated Care Manager who is eager to apply their medical knowledge in a hands-on, patient-facing role. This position is ideal for someone with a healthcare diploma, training, or any form of medical education or clinical exposure who wants to put that foundation to meaningful use. You'll act as the central point of contact for patients, helping them understand their conditions, navigate care plans, and stay on track with treatment while working alongside providers, social workers, and community partners. Key Responsibilities: Monitor and coordinate care plans by tracking progress, adjusting interventions, and maintaining consistent patient support. Provide clear, accessible education about chronic conditions, treatment options, and lifestyle strategies. Coordinate appointments, follow-ups, and referrals, ensuring smooth connection to appropriate providers. Maintain accurate patient records, including health information, insurance details, and supporting documentation. Respond promptly and empathetically to patient questions, concerns, and urgent needs. Partner with care teams to develop, assess, and refine patient-centered interventions. Collaborate with behavioral health, disease management, home health, social work, and community organizations for holistic care. Ideal Qualities and Skills: Strong verbal and written communication skills and the ability to simplify medical information for patients. Fluency in Spanish (spoken and written), with the ability to support Spanish-speaking patients and families. Solid problem-solving instincts and a proactive approach to anticipating patient needs. Organized, detail-oriented, and reliable in managing patient caseloads and documentation. Comfortable prioritizing tasks and managing time effectively in a remote environment. Collaborative mindset with genuine care for patient well-being. Healthcare diploma or equivalent preferred. Any level of medical or healthcare experience-clinical rotations, internships, coursework, or similar-is welcomed. Compensation: Competitive hourly rate of $15-$20 per hour, based on experience and qualifications (Full Time). A supportive remote environment with opportunities for professional growth and development. Fully Remote opportunity.

LOCATION: Remote - must live in or near Chatham County, North Carolina. The person in this position must maintain residency in North Carolina or within 40 miles of the North Carolina border. This position requires travel. GENERAL STATEMENT OF JOB The Care Manager is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (“members”) to ensure that these individuals receive appropriate assessment and services. The Care Manager works with the member and care team to alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services needed by the member across the MH, SU, intellectual/ developmental disability (“I/DD”), traumatic brain injury (“TBI”) physical health, pharmacy, long-term services and supports (“LTSS”) and unmet health-related resource needs networks. Care Managers support and may provide transition planning assistance to state, and community hospitals and residential facilities and track individuals discharged from facility settings to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations, including members' home communities. The Care Manager also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. As further described below, essential job functions of the Care Manager include, but may not be limited to: Utilization of and proficiency with Vaya's Care Management software platform/ administrative health record (“AHR”) Outreach and engagement Compliance with HIPAA requirements, including Authorization for Release of Information (“ROI”) practices Performing Health Risk Assessments (HRA): a comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas to ensure a whole person approach to care Adherence to Medication List and Continuity of Care processes Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management Transitional Care Management Diversion from institutional placement This position is required to meet NC Residency requirements as defined by the NC Department of Health and Human Services (“NCDHHS” or “Department”). This position is required to live in or near the counties served to effectively deliver in-person contacts with members and their care teams. ESSENTIAL JOB FUNCTIONS Assessment, Care Planning, and Interdisciplinary Care Team: Ensures identification, assessment, and appropriate person-centered care planning for members. Links members with appropriate and necessary formal/ informal services and supports across all health domains (i.e., medical, and behavioral health home) Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs. Administer the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings within their scope based on member's needs. The Care Manager uses these screenings to provide specific education and self-management strategies as well as linkage to appropriate therapeutic supports. The assessment process includes reviewing and transcribing member's current medication and entering information into Vaya's Care Management platform, which triggers the creation of a multisource medication list that is shared back with prescribers to promote integrated care. Supports the care team in development of a person-centered care plan (“Care Plan”) to help define what is important to members for their health and prioritize goals that help them live the life they want in the community of their choice. Ensure the Care Plan includes specific services to address mental health, substance use, medical and social needs as well as personal goals Ensure the Care Plan includes all elements required by NCDHHS Use information collected in the assessment process to learn about member's needs and assist in care planning Ensure members of the care team are involved in the assessment as indicated by the member/LRP and that other available clinical information is reviewed and incorporated into the assessment as necessary Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions Reviews clinical assessments conducted by providers and partners with Care Manager - LP and Care Manager Embedded - LP for clinical consultation as needed to ensure all areas of the member's needs are addressed. Help members refine and formulate treatment goals, identifying interventions, measurements, and barriers to the goals Ensures that member/legally responsible person (“LRP”) is/are informed of available services, referral processes (e.g., requirements for specific service), etc. Provides information to member/LRP regarding their choice of service providers, ensuring objectivity in the process Works in an integrated care team including, but not limited to, an RN (Registered Nurse) and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP have the opportunity to decide who they want involved Supports and may facilitate care team meetings where member Care Plan is discussed and reviewed Solicits input from the care team and monitor progress Ensures that the assessment, Care Plan, and other relevant information is provided to the care team Reviews assessments conducted by providers and consults with clinical staff as needed to ensure all areas of the member's needs are addressed Updates Care Plans and Care Management assessment at a minimum of annually or when there is a significant life change for the member Supports and assists with education and referral to prevention and population health management programs. Works with the member/LRP and care team to ensure the development of a Care Management Crisis Plan for the member that is tailored to their needs and desires, which is separate and complementary to the behavioral health provider's crisis plan. Provides crisis intervention, coordination, and care management if needed while with members in the community. Supports Transitional Care Management responsibilities for members transitioning between levels of care Coordinates Diversion efforts for members at risk of requiring care in an institutional setting Consults with care management licensed professionals, care management supervisors, and other colleagues as needed to support effective and appropriate member care. Collaboration, Coordination, Documentation: Serves as a collaborative partner in identifying system barriers through work with community stakeholders. Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate. Works in partnership with other Vaya departments to identify and address gaps in services/ access to care within Vaya's catchment. Participates in cross-functional clinical and non-clinical meetings and other projects as needed/ requested to support the department and organization. Participates in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CMs (Care Manager) and receiving support and feedback regarding CM interventions for clients' medical, behavioral health, intellectual /developmental disability, medication, and other needs. Works with Care Manager - LP and Care Manager Embedded - LP in participating in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system. Monitors provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards. Ensures the health and safety of members receiving care management, recognize and report critical incidents, and escalate concerns about health and safety to care management leadership as needed. Supports problem-solving and goal-oriented partnership with member/LRP, providers, and other stakeholders. Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues. Supports and assists members/families on services and resources by using educational opportunities to present information. Verifies member's continuing eligibility for Medicaid, and proactively responds to a member's planned movement outside Vaya's catchment area to ensure changes in their Medicaid county of eligibility are addressed prior to any loss of service. Proactively and timely creates and monitors documentation within the AHR to ensure completeness, accuracy and follow through on care management tasks. Maintains electronic AHR compliance and quality according to Vaya policy. Works with Care Manager - LP and Care Manager Embedded - LP to ensure all clinical and non-clinical documentation (e.g. goals, plans, progress notes, etc.) meet all applicable federal, state, and Vaya requirements, including requirements within Vaya's contracts with NCDHHS. Participates in all required Vaya/ Care Management trainings and maintains all required training proficiencies. Other duties as assigned. KNOWLEDGE, SKILLS, & ABILITIES Ability to express ideas clearly/concisely and communicate in a highly effective manner Ability to drive and sit for extended periods of time (including in rural areas) Effective interpersonal skills and ability to represent Vaya in a professional manner Ability to initiate and build relationships with people in an open, friendly, and accepting manner Attention to detail and satisfactory organizational skills Ability to make prompt independent decisions based upon relevant facts. Well-developed capabilities in problem solving, negotiation, arbitration, and conflict resolution, including a high level of diplomacy and discretion to effectively negotiate and resolve issues with minimal assistance. A result and success-oriented mentality, conveying a sense of urgency and driving issues to closure Comfort with adapting and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change Thorough knowledge of standard office practices, procedures, equipment, and techniques and intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.), and Vaya systems, to include the care management platform, data analysis, and secondary research Understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) within their scope and have considerable knowledge of the MH/SU/IDD/TBI service array provided through the network of Vaya providers. Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements are preferred. Ability to complete and maintain all trainings and proficiencies required by Vaya, however delivered, including but not limited to the following: BH I/DD Tailored Plan eligibility and services Whole-person health and unmet resource needs (ACEs, trauma-informed care, cultural humility) Community integration (independent living skills; transition and diversion, supportive housing, employment, etc.) Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.) Health promotion (common physical comorbidities, self-management, use of IT, care planning, ongoing coordination) Other care management skills (transitional care management, motivational interviewing, person-centered needs assessment and care planning, etc.) Serving members with I/DD or TBI (understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.) Serving children (child-and family-centered teams, Understanding the “System of Care” approach) Serving pregnant and postpartum women with SUD or with SUD history Serving members with LTSS needs (Coordinating with supported employment resources Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position. EDUCATION & EXPERIENCE REQUIREMENTS Bachelor's degree required, preferably in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. Serving members with BH conditions: Two (2) years of experience working directly with individuals with BH conditions Serving members with LTSS needs Two (2) years of prior Long-term Services and Supports (LTSS) and/or Home Community Based Services (HCBS) coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working directly with individuals with BH conditions, an I/DD, or a TBI, described above --If graduate of a college or university with a Bachelor's degree in Human Services, then incumbent must have two years of full-time accumulated experience in mental health with population served. --If graduate of a college or university with a Bachelor's degree is in field other than Human Services, then incumbent must have four years of full-time accumulated experience in mental health with population served. --If a graduate of a college or university with a Bachelor's Degree in Nursing and licensed as RN, then incumbent must have four years of full-time accumulated experience in mental health with population served. Experience can be before or after obtaining RN licensure. --If graduate of a college or university with a Master's level degree in Human Services, although only one year of experience is needed to reach QP status, the incumbent must still have at least two years of full-time accumulated experience in mental health with the population served *Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104 Licensure/Certification Required: If Incumbent has a Bachelor's degree in nursing and RN, incumbent must be licensed by the North Carolina Board of Nursing to practice in the State of North Carolina. Preferred work experience: Experience working directly with individuals with I/DD or TBI PHYSICAL REQUIREMENTS Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. Mental concentration is required in all aspects of work. Ability to drive and sit for extended periods of time (including in rural areas) RESIDENCY REQUIREMENT: The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border. SALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation. DEADLINE FOR APPLICATION: Open Until Filled APPLY: Vaya Health accepts online applications in our Career Center, please visit ****************************************** Vaya Health is an equal opportunity employer.