- Humana (Jefferson City, MO)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Humana (Jefferson City, MO)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are… more
- Humana (Jefferson City, MO)
- …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
- Centene Corporation (Jefferson City, MO)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- CVS Health (Jefferson City, MO)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channels + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
- Humana (Jefferson City, MO)
- …value-based care, quality metrics, population health , and disease or care management . The Behavioral Health Medical Director may develop procedures, ... part of our caring community and help us put health first** The Behavioral Health ...management , utilization management , case management , discharge planning and/or home health or… 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
- Evolent (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...internal departments. The Analyst conducts audits of Medical Directors, Utilization Management (UM) and Case Management… more
- Intermountain Health (Jefferson City, MO)
- …related field including Utilization Management , discharge planning, managed care, health promotion, health coaching, behavioral health , quality, ... **Job Description:** Select Health is a community health plan...behavioral , and social needs of members while promoting self- management , quality, and cost-effective outcomes. **Essential Functions** + The… more