- Humana (Baton Rouge, LA)
- …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
- Evolent (Baton Rouge, LA)
- …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 (Baton Rouge, LA)
- …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
- Immigration and Customs Enforcement (Jena, LA)
- …improvement activities/risk identification and management directly related to mental health . Coordinates alongside HQ behavioral health unit for ... Summary The Supervisory Behavioral Health Provider oversees clinical performance,...hunger strike, abuse, neglect and trauma, and integrative case management . Establishes and maintains liaison with other health… more
- Centene Corporation (Baton Rouge, LA)
- …benefits including a fresh perspective on workplace flexibility. **We're Hiring: Full-time Behavioral Health Medical Director** Centene Corporation is a leading ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality… more
- CVS Health (Baton Rouge, LA)
- …acknowledges physicians for their clinical excellence and effective utilization of health care resources. Reporting to the Executive Behavioral Health ... members across Aetna. **Expectations and Responsibilities:** * Serve as the principal utilization management reviewer for cases related to Applied Behavior… more
- Highmark Health (Baton Rouge, LA)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving ... function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Baton Rouge, LA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- CVS Health (Baton Rouge, LA)
- …time. + Ability to interface with customers/clients. + 2+ years' experience in behavioral health , social services or appropriate related field equivalent to ... At CVS Health , we're building a world of health...coordination, support, and education through the use of care management resources in order to facilitate appropriate healthcare outcomes… more
- Highmark Health (Baton Rouge, LA)
- …residency program + 5 - 7 years in Pharmacy + 3 - 5 years in Pharmacist - Utilization Management + 3 - 5 years in Pharmacist - Medical Therapy Management ... are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent then conducts thorough research to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more