- Centene Corporation (New York, NY)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- Helio Health Inc. (Syracuse, NY)
- …mission to treat and promote recovery from the effects of substance use, mental health disorders, and other behavioral healthcare issues. To support the mission ... staff on current principles and standards of practice surrounding utilization and denials management . + Use effective...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
- Guidehouse (New York, NY)
- …nursing. + New York Nursing License - REQUIRED + 4+ years of experience in utilization management + Familiarity with MCG and InterQual guidelines + Ability to ... certification + Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis...form **What Would Be Nice To Have** **:** + Behavioral Health Experience + Skilled Nursing Facility… more
- CenterWell (Albany, NY)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
- CenterWell (Albany, NY)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
- Humana (Albany, NY)
- …value-based care, quality metrics, population health , and disease or care management . The Behavioral Health Medical Director may develop procedures, ... part of our caring community and help us put health first** The Behavioral Health ...management , utilization management , case management , discharge planning and/or home health or… more
- Elevance Health (Latham, NY)
- …work-life integration, and ensures essential face-to-face onboarding and skill development. The ** Behavioral Health Care Manager II** is responsible for managing ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Garnet Health (Harris, NY)
- …to make your career home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health Medical Center-Catskill. ... patients. The Clinician is also responsible for obtaining insurance approval for inpatient behavioral health treatment, making sure that correct legal papers are… more
- Villa of Hope (Rochester, NY)
- JOB TITLE: Clinical Director of Behavioral Health Residential & School Programs POSITION GRADE: 86 DEPARTMENT/PROGRAM: Tuckahoe, LHTC, & School Clinicians ... the general direction of the Chief Program Officer, the Clinical Director of Behavioral Health will provide clinical and operational leadership to the Tuckahoe… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …clinical leadership and support for the development and implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH ... Essential Responsibilities/Accountabilities: + Leads, develops, and implements the Children's Behavioral Health Carve-In program following NYS directives and… more