- Humana (Lincoln, NE)
- …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
- Molina Healthcare (Omaha, NE)
- …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
- CenterWell (Lincoln, NE)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
- Humana (Lincoln, NE)
- …clinical services . Experience in utilization management review and case management in a health plan setting . No current sanction from Federal or ... part of our caring community and help us put health first** The Behavioral Health ...a focus on collaborative business relationships, value-based care, population health , or disease or care management +… more
- CVS Health (NE)
- …program performance support including developing cost/staffing models for Behavioral Health Programs - Utilization Management (Intake & Concurrent ... reports and visualizations, providing strategic recommendations based on data insights. Provide Behavioral Health medical cost and utilization analysis… more
- Molina Healthcare (NE)
- …or more of the following areas: utilization management , care management , care transitions, behavioral health , or equivalent combination of relevant ... Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification. * Leadership experience. *… more
- Highmark Health (Lincoln, NE)
- …drug policy, therapeutic alternatives, medication adherence strategies, Medication Therapy Management , utilization management , immunizations, specialty ... Pharmacy **Substitutions** + None **Preferred** + Master's Degree in Health Administration or Business or + Doctorate Degree in...+ Healthcare + Care Planning + Continuous Improvement + Utilization Management + Healthcare Management … more
- Highmark Health (Lincoln, NE)
- …:** **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
- Highmark Health (Lincoln, NE)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... decisions, ensuring alignment with the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care received, and optimal… more
- Veterans Affairs, Veterans Health Administration (Omaha, NE)
- …and implement an integrated pain management approach that maximizes the utilization of complementary and integrative health therapies and active pain ... professional advice and consultation in areas related to professional psychology and behavioral health . Knowledge of clinical research literature. Reference: For… more