- Centene Corporation (New York, NY)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- 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
- Humana (Albany, NY)
- …care management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and ... part of our caring community and help us put health first** The Behavioral Health ...insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review… more
- Guidehouse (New York, NY)
- …based on physician certification + Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis + Performs ... None **What You Will Do** **:** + Performs chart review of identified patients to identify quality, timeliness and...form **What Would Be Nice To Have** **:** + Behavioral Health Experience + Skilled Nursing Facility… 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 ... or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review ....Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Garnet Health (Harris, NY)
- …the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. At Garnet Health , we are committed to ... 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
- Gateway-Longview (Williamsville, NY)
- …+ In collaboration with the Asst. Directors, monitor overall staff productivity and utilization of the Behavioral Health Services department and respective ... Job Title: Clinical Supervisor - Behavioral Health Clinic Department: Behavioral...consistent basis and provide feedback to assure productivity and utilization is met + In collaboration with the Assistant… more
- Apicha Community Health Center (New York, NY)
- …to Quality Improvement and Quality Assurance activities. + Participate in the development and review of Apicha's behavioral health policies and procedures. + ... environment for underserved and vulnerable populations. Position summary: Provides clinical behavioral health services to all age patients/families in Apicha… more
- CenterWell (Albany, NY)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN...medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- CenterWell (Albany, NY)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** Healthcare isn't just about health ...medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more