- Molina Healthcare (Phoenix, AZ)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- …serve as the subject matter expert for the discipline. Senior LPMHCs develop behavioral health related training curriculum and often conduct trainings for ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible... Counselor (PLMHC) is a member of the Mental Health & Behavioral Sciences (MHBS) Service line… more
- Highmark Health (Phoenix, AZ)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... and stakeholders across the organization. Key responsibilities will include clinical review , assisting in navigating a complex regulatory environment, working with… more
- Adelante (Goodyear, AZ)
- … health issues and provider's education to assist with enhancing primary care utilization of behavioral health interventions + Promote a smooth interface ... will be responsible for completing initial intakes for the behavioral health program. The therapist will make...recommendations for a portion of these patients by record review without seeing the patients. The therapist will contact… more
- Adelante (Phoenix, AZ)
- … health issues and providers education to assist with enhancing primary care utilization of behavioral health interventions + Promotes a smooth interface ... will be responsible to complete initial intakes for the behavioral health program. The therapist will make...recommendations for a portion of these patients by record review without actually seeing the patients. The therapist will… more
- Highmark Health (Phoenix, AZ)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- Highmark Health (Phoenix, AZ)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- Banner Health (Sun City West, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a ... Name:** Case Mgmt-Hosp **Work Shift:** Day **Job Category:** Clinical Care Banner Health was recently recognized on Forbes inaugural list of America's Dream… more
- Adelante (Mesa, AZ)
- …Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations POSITION REPONSIBILITIES + Reports to the Regional Medical ... Women's Health Nurse Practitioner - Mesa, AZ Job Details...the review of protocols and procedures + Review results of utilization and quality monitoring… more
- Highmark Health (Phoenix, AZ)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more