- Humana (Frankfort, KY)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are… more
- Humana (Frankfort, KY)
- …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
- Molina Healthcare (Bowling Green, KY)
- …**Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- CVS Health (Frankfort, KY)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channels + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
- CVS Health (Frankfort, KY)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channels. + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
- Humana (Frankfort, KY)
- …value-based care, quality metrics, population health , and disease or care management . The Behavioral Health Medical Director may develop procedures, ... part of our caring community and help us put health first** The Behavioral Health ...management , utilization management , case management , discharge planning and/or home health or… more
- Molina Healthcare (Bowling Green, KY)
- …services activities for care management , care review, utilization management , transitions of care, behavioral health , long-term services and ... Molina's clinical/healthcare services function, which may include care review, care management , and/or correspondence processing, etc. * Researches and analyzes the… more
- CVS Health (Frankfort, KY)
- …care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Elevance Health (Louisville, KY)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... **Medical Director-Pain Management /Anesthesia Appeals** **Location:** This role enables associates to...is responsible for the review of appeals for physical health medical services, to ensure the appropriate and most… more