- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Centene Corporation (Springfield, IL)
- …experience in various mental health settings especially inpatient behavioral health units, utilization management / review, and youth or pediatric ... services.** Additional Details: * Department: Illinois Utilization Management * Business Unit: Illinois Health Plan * Schedule: Monday through Friday 8-4:30… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- Evolent (Springfield, IL)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Carle Health (Champaign, IL)
- …related to utilization management , case management and clinical denials management . + The Behavioral Health Physician Advisor is also expected to ... the Clinical Denial Management Team, and other health care professionals. + The Behavioral ...Management staff /Social Work (remove) Utilization management and Clinical Denials Team/or other health … more
- Highmark Health (Springfield, IL)
- …coverage 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 appropriately to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Chicago, IL)
- ** Behavioral Health Care Manager II -...is licensed staff supervision. + Previous experience in case management / utilization management with a broad ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...Beacon Health Options, offers superior clinical mental health and substance use disorder management , a… more
- Humana (Springfield, IL)
- …administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and ... specialists + Develops comprehensive care programs for the management of adult behavioral health ...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
- Elevance Health (Chicago, IL)
- ** Behavioral Health - Care Manager II** **Location:** _Virtual:_ This role enables associate to work virtually full-time, with the exception of required ... an accommodation is granted as required by law. The ** Behavioral Health - Care Manager II** is...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- CVS Health (Springfield, IL)
- …and/or home health care coordination. **Preferred Qualifications** + Case management and discharge planning experience. + Managed care/ utilization review ... and strategies, policies and programs are comprised of network management , clinical coverage, and policies. **Position Summary** Our Case...Minimum of 3-5 years of clinical experience, preferably in behavioral health . + Minimum of 2-3 years… more