- CenterWell (Austin, TX)
- …+ 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
- Healthfirst (NY)
- …**Collaborate closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health , and Appeals and ... 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
- Centene Corporation (Harrisburg, PA)
- …EASTERN TIME ZONE/CENTRAL TIME ZONE.** **IDEAL APPLICANTS WILL HAVE CHILDREN/ADOLECENT BEHAVIORAL HEALTH EXPERIENCE AND HOLD A PENNSYLVANIA LICENSURE.** ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder… more
- MVP Health Care (Rochester, NY)
- …For in New York** , and an **Inclusive Workplace** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental ... improvement. To achieve this, we're looking for a **Professional, Behavioral Health ** to join #TeamMVP. If you...with at least 2 years being ASD related + Utilization or Case Management experience in a… more
- South Middlesex Opportunity Council (Framingham, MA)
- …casual Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact with ... Summary: SMOC Behavioral Healthcare is a division of SMOC that...division of SMOC that provides substance abuse and mental health outpatient services to individuals, children and families. This… more
- Banner Health (Scottsdale, AZ)
- …Shift:** Day **Job Category:** Clinical Care For more than 30 years, Banner Behavioral Health Hospital has provided a nationally recognized, behavioral ... program for children, teens and adults faced with psychiatric, behavioral health , or chemical dependency challenges. We...continuum of care. 7. Educates internal members of the health care team on case management and… more
- Banner Health (Glendale, AZ)
- …want to be part of, we want to hear from you. Bring your passion for Behavioral Health to **Banner Thunderbird Medical Center- BTMC!** Our Behavioral ... mental health diagnoses as well as those behavioral health patients whom have co-morbidities that...continuum of care. 7. Educates internal members of the health care team on case management and… more
- Corewell Health (Grand Rapids, MI)
- …stay reviews and appeals. Additional support to the UM functions of the Corewell Health South Behavioral Health Inpatient unit. + Assesses internal and ... recommendations to PCPs, specialists and other members of the health care team regarding care management strategies,...of the health care team regarding care management strategies, identifying strategies to maximize continuity of care… more
- BriteLife Recovery (Englewood, NJ)
- …in utilization review, case management , or insurance coordination in a behavioral health or substance use treatment setting. + Knowledge of ASAM criteria ... and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? +...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- East Boston Neighborhood Health Center (MA)
- …Locations: 1601 Washington Street Position Summary: Under the direction of the Chief Behavioral Health Officer, the Administrative Director is an agent of change ... who oversees the overall clinical quality and operations for the Department of Behavioral Health our South End location, which includes the Integrated … more