- UPMC (Delmont, PA)
- …that include the medical, behavioral , pharmacy, and social needs of the member. Review UPMC Health Plan data and documentation in the member electronic ... and modify the care plan with member, caregivers, PCP, specialists, community resources, behavioral health contractor, and other health plan and system… more
- St. Luke's University Health Network (Allentown, PA)
- …pay for health care. The Music Therapist serves as a licensed behavioral health professional within the interdisciplinary treatment team of the Acute Partial ... as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless… more
- Highmark Health (Buffalo, NY)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Buffalo, NY)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- HCA Healthcare (Kansas City, MO)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... 156,000 hours volunteering in our communities. As a Mental Health Professional III Licensed with Research Psychiatric Center you...in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Complete all application requirements detailed in the ... the patient. ii. Knowledge to interpret and apply all health and safety regulations, to minimize and mitigate risks...care; develop and select interventions to achieve patient goals; review patient progress; adapt or adjust the treatment plan… more
- New York State Civil Service (Valatie, NY)
- …experimental psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc. Additional Comments ... homes, as well as discipline-specific projects, including assisting with enhancing utilization of electronic health records, participation in relevant committees… more
- CenterWell (Nashville, TN)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- BrightSpring Health Services (Dunbar, WV)
- …submit to State Health Services Director and Assigned Director, Clinical Practice* Review utilization report at least monthly to ensure adequate hours on ... community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote… more
- Ascension Health (Racine, WI)
- …areas of responsibility, to include but not limited to; + Quality and Safety + Utilization Review + Peer Review and Credentialing + Growth and Strategic ... conduct. Ensures adherence and completion of medical staff decisions regarding peer review and physician behavioral issues. + Leads the development of… more