- Buckeye Community Health Plan (Thornville, OH)
- …certification in general psychiatry or child psychiatry. 5+ years of experience working in behavioral health managed care or behavioral health clinical ... order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex,… more
- Monogram Health (Fort Myers, FL)
- …specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health , and palliative care to diagnose and ... physicians who are dedicated to improving the well-being, quality of life, and health outcomes for our patients. We partner with the nation's leading clinical… more
- Monogram Health (Jacksonville, FL)
- …Medicaid populations, as well as commercial populations?? Experience integrating acute and behavioral health care and appreciation of social determinants of ... Monogram Health is seeking a full-time physician, specialized in...of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services… more
- HCA Healthcare - Chief Medical Officer (San Antonio, TX)
- …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 ... Texsan, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care organization desired… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …a member's benefit coverage while working remotely. Primary Responsibilities * Performs behavioral health clinical utilization reviews using evidenced based ... About The Role BHPS provides Utilization Management services to its clients. The ...* Experience with both inpatient and outpatient reviews for Behavioral Health (examples: TMS, ECT, ABA, Psychotherapy,… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with initial assessments, as… more
- Molina Healthcare (Bowling Green, KY)
- …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
- CVS Health (Oklahoma City, OK)
- …to identify and address patient needs (eg care team, social work, behavioral health , utilization management, Hard-to-Reach, Central Telehealth, etc.). ... assurance activities. **What are we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing within the state of… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Purpose:** Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management, Care Management,… more
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