- Humana (Lansing, MI)
- …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
- Henry Ford Health System (Troy, MI)
- …implements and executes strategies for related to HAP's population health focus (care management , utilization management , behavioral health ) to ... and authority KEY RELATIONSHIPS:Senior Vice President, Chief Medical Officer AVP, Population Health Management AVP, Quality Improvement and Management Senior… more
- Molina Healthcare (Grand Rapids, MI)
- …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 (Ann Arbor, MI)
- …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
- Tenet Healthcare (Detroit, MI)
- … Health patient care experience required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN ... national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention… more
- Evolent (Lansing, MI)
- …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 (Lansing, MI)
- …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
- Fairview Health Services (Highland Park, MI)
- …and Quality named MHealth Fairview Clinics as one of eight "exemplar" integrated behavioral health primary care models across the country. Integrated care is ... a result of an engaged primary care team and Behavioral Health Clinician providing patient-centered care addressing...determinants of health , and ineffective patterns of health care utilization . At MHealth Fairview, integrated… more
- McLaren Health Care (Pontiac, MI)
- …performance and/or leadership of patient care team members and patient care management staff. Assists in the coordination of patient care through the appropriate ... utilization of all resources; staff, equipment, supplies, etc. **Essential...to patient care by the medical staff and other health care professionals to provide optimal patient care. 11.… more
- Corewell Health (Grand Rapids, MI)
- … Management leadership, coordinates the educational plan for the Behavioral Health , Care Management , and Utilization Management departments. ... plans for staff. Reports to either a Director of Behavioral Health , Care Management , or Utilization Management with matrix reporting to other… more