- Humana (Columbus, OH)
- …caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
- Humana (Columbus, OH)
- …Qualifications** + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health ; MED-Deeming ... degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management +...standards knowledge is a plus. + Registered Nurse or Behavioral Health Licensed Professional . +… more
- Molina Healthcare (Cleveland, OH)
- …Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- Elevance Health (Cincinnati, OH)
- …informed, culturally competent, person‐centered coordination for all members that addresses physical health , behavioral health , long term services and ... ** Utilization Management Representative II** **Schedule: Monday-Friday 8am-5pm Eastern...Cincinnati, Mason, Columbus or Seven Hills, Ohio** **Location:** Elevance Health operates in a Hybrid Workforce Strategy. Unless specified… more
- Elevance Health (Independence, OH)
- ** Behavioral Health Care Manager II** Carelon...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or… more
- Bon Secours Mercy Health (Oregon, OH)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more
- Elevance Health (Independence, OH)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... vision and implementation to deliver an improvement in the health of the people we serve. The medical director...medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the… more
- Elevance Health (Dayton, OH)
- …informed, culturally competent, person‐centered coordination for all members that addresses physical health , behavioral health , long term services and ... plan. Engage the individual's support network and oversee management of their physical health , behavioral health , and long-term services and supports,… more
- Elevance Health (Grove City, OH)
- …culturally competent, person_ _‐centered coordination for all members that addresses physical health , behavioral health , long term services and supports, ... Services** is responsible for the administration of physical and/or behavioral health medical services, to ensure the...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Humana (Columbus, OH)
- …Improvement, Utilization Management, Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Long-Term Services and Supports, ... part of our caring community and help us put health first** The Senior Strategy Advancement Professional ...put health first** The Senior Strategy Advancement Professional will support initiatives to develop and execute strategy… more