- CVS Health (Jefferson City, MO)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... ambulatory care or outpatient clinic/facility. + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
- Lincoln Financial (Jefferson City, MO)
- …including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health case management ... **The Role at a Glance** We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization. As a Behavioral … more
- Highmark Health (Jefferson City, MO)
- …:** **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
- Elevance Health (St. Louis, MO)
- …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... medical director provides clinical expertise in all aspects of utilization review and case management . Provides input...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Highmark Health (Jefferson City, MO)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Highmark Health (Jefferson City, MO)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... processing of pre-certification requests for authorization of medically necessary health care services, at the appropriate level of care,...and management . + Route Cases Based on Established Guidelines. +… more
- Children's Mercy Kansas City (Kansas City, MO)
- …patient progression activities during the patient's hospital course, supporting utilization management functions, and administrative functions for the ... patient progression activities during the hospital stay. + Supports Utilization Management functions for Care Management...hospital setting and / or working in field of behavioral health preferred + HS diploma or… more
- CVS Health (Jefferson City, MO)
- …. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience.… more
- Peoples Health Centers Family of Companies (St. Louis, MO)
- Behavioral Health | Full Time Job Description About Us: BJK People's Health Centers provides comprehensive mental health services to children and adults ... needs. * Contributes to development of a recovery oriented care plans that address behavioral health , medical, and social barriers for persons served. The plans… more
- Peoples Health Centers Family of Companies (St. Louis, MO)
- …1) Functions in accordance with the policies of Betty Jean Kerr People's Health Centers Behavioral Health Division, state and federal regulation, ... or a related field and two years of post-master's experience in a behavioral health setting. Residential experience preferred. CERTIFICATION OR LICENSE REQUIRED:… more