- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Molina Healthcare (Buffalo, NY)
- …most effective setting while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, ... expertise for utilization management, case management, and integrated behavioral health /chemical dependency programs; collaborates with regional and… more
- Evolent (Albany, NY)
- …which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be… more
- Molina Healthcare (Syracuse, NY)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- Highmark Health (Albany, NY)
- …determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... prior authorization or appeals against medical policy through the Utilization Review system. Update the system records...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Latham, NY)
- …abuse cases preferred. **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly preferred. + ... Behavioral Health Care Manager I- ...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review .… more
- Elevance Health (Middletown, NY)
- …Care Manager II** is responsible for managing autism services and behavioral health treatment benefits through written review . **How you will make an ... ** Behavioral Health Care Manager II -...requirement for this position. + Previous experience in case management/ utilization management with a broad range of experience with… more
- Elevance Health (Latham, NY)
- ** Behavioral Health Care Manager I - Ameriben** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... of medical benefits, including medical management. **Hours: 8am-5pm (Local time)** The ** Behavioral Health Care Manager I** is responsible for managing adult… more
- Healthfirst (NY)
- …other Operations leaders including but not limited to Care Management, Clinical Eligibility, Behavioral Health , and Appeals and Grievances teams to align ... set forth by CMS, New York State Department of Health (DOH), and other oversight entities + Develop and...improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for… more
- Garnet Health (Harris, NY)
- …for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. Join the Garnet Health team and let your ... your career home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health Medical Center-Catskill. Responsibilities… more