- 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 (KY)
- …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
- Molina Healthcare (Bowling Green, KY)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- Molina Healthcare (Owensboro, KY)
- …while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective ... psychiatric leadership and clinical expertise for utilization management , case management , and integrated behavioral health /chemical dependency… more
- CVS Health (Frankfort, KY)
- …clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... + Must reside in Kentucky or bordering Counties + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT,… more
- Evolent (Frankfort, KY)
- …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
- Highmark Health (Frankfort, KY)
- …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 (Louisville, KY)
- ** Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... Monday - Friday. Half day Saturday rotation, once a month.** The ** Behavioral Health Medical Director-Psychiatrist Appeals** is responsible for the… more
- Elevance Health (Louisville, KY)
- …medical benefits, including medical management . **Hours: 8am-5pm (Local time)** The ** Behavioral Health Care Manager I** is responsible for managing adult ... ** Behavioral Health Care Manager I -...** Behavioral Health Care Manager I - Ameriben** **Location** :...Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad… more
- Molina Healthcare (Covington, KY)
- …or more of the following areas: utilization management , care management , care transitions, behavioral health , or equivalent combination of relevant ... Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification. * Leadership experience. *… more
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