- Humana (St. Paul, MN)
- …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 (St. Paul, MN)
- …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 (St. Paul, MN)
- …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 (Minneapolis, MN)
- …and Quality named MHealth Fairview Clinics as one of eight "exemplar" integrated behavioral health primary care models across the country. Integrated care is ... the 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
- Fairview Health Services (Princeton, MN)
- …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
- Fairview Health Services (Minneapolis, MN)
- …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
- Fairview Health Services (Edina, MN)
- …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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …concentration in Substance Use Disorders is a critical component of the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical ... Blue Cross and Blue Shield of Minnesota Position Title: Behavioral Health Care Advisor - Substance Use...* 1+ years of managed care experience, eg case management / health coach, utilization management… more
- Highmark Health (St. Paul, MN)
- …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 (St. Paul, MN)
- …:** **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
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