- Highmark Health (Phoenix, AZ)
- …Benefits, Customer Service, Membership & Billing), Provider Data Management , Underwriting, and Professional Relations. **ESSENTIAL RESPONSIBILITIES** + Provide ... including gathering data from multiple sources related to Benefit/Claim Utilization , Enrollment, Networks ( utilization , disruption, geo-access) and making… more
- CVS Health (Phoenix, AZ)
- …years of Administrative and Customer Support work experience in healthcare and/or behavioral health field. + Advanced proficiency with technology including ... At CVS Health , we're building a world of health...EAP On-Site Counseling Program, ensuring customer satisfaction and successful utilization of the EAP On-Site product, services, and solutions.… more
- Devereux Advanced Behavioral Health (Scottsdale, AZ)
- …or Social Work + Required: Independent Licensure through Arizona Board of Behavioral Health Examiners (LPC or LCSW); Current approved Clinical Supervisor ... _Clinical_ **_Position Type_** _Full-Time_ The employment policies of Devereux Advanced Behavioral Health are to recruit and hire qualified employees… more
- Adelante (Peoria, AZ)
- …with the medical team including the medical providers and medical assistance in the utilization of behavioral health services + Utilize AZARA reports to ... POSITION SUMMARY The Integrated Care Coordinator works collaboratively with the Behavioral Health Consultant, providers, and the Integrated Behavioral… more
- Highmark Health (Phoenix, AZ)
- …Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case Management… more
- Banner Health (Sun City West, AZ)
- … utilization and regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates ... regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained...through the completion of a bachelor's degree in case management or health care. Requires current Registered… more
- Sharecare (Phoenix, AZ)
- …members to become empowered and active participants in their own healthcare management for their chronic condition. By providing health education and ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management… more
- Highmark Health (Phoenix, AZ)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- Molina Healthcare (Tucson, AZ)
- …Masters Degree in Behavior Analysis or a related field. **Preferred Experience** Utilization Management experience Health Plan/MCO work experience ... an integrated delivery of care across the continuum, including behavioral health and long term care, for...requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide… more
- Highmark Health (Phoenix, AZ)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more