- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Utilization Review Services Coordinator? At Parallonr, you come first. HCA Healthcare has ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...make a difference. We are looking for a dedicated Utilization Review Services Coordinator like you to… more
- Elevance Health (Nashville, TN)
- …employment, unless accommodation is granted as required by law. **Work Shift:** 8AM -5PM CST ** Behavioral Health Care Manager l** The ** Behavioral Health ... or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review ....Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- **Join Our Team as a Medical Review Director\- Behavioral Health \!** Are you a dedicated and experienced medical professional with a passion for quality ... We are seeking a self\-motivated and detail oriented Medical Review Director to lead our team in ensuring the...board\-certified psychiatrist with management experience in the areas of behavioral health and addiction medicine\. We're looking… more
- HCA Healthcare (Nashville, TN)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... an organization that invests in you as a Quote Review Analyst? At HealthTrust, you come first. HCA Healthcare...HealthTrust, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Highmark Health (Nashville, TN)
- …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more
- Highmark Health (Nashville, TN)
- …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- Humana (Nashville, TN)
- …you will need to be well versed in CMS knowledge of outpatient, inpatient, behavioral health and appeal criteria including regulation and policies. You much also ... + Deep understanding of regulatory environment and medical investigations within the utilization management and behavior health utilization management.… more
- Highmark Health (Nashville, TN)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- HCA Healthcare (Chattanooga, TN)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with...growth, we encourage you to apply for our Mental Health Therapist - Outpatient opening. We promptly review… more