- Humana (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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
- CVS Health (Nashville, TN)
- …+ 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 (Nashville, TN)
- …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
- BlueCross BlueShield of Tennessee (Murfreesboro, TN)
- The Behavioral Health Case Manager for Transitions of Care is dedicated to proactive engagement with members admitted to Acute Inpatient Psychiatric facilities\. ... This role involves coordinating care to address immediate behavioral health needs and overcoming barriers to discharge from inpatient care\. The goal is to… more
- Signature Healthcare (Monteagle, TN)
- …consultation to facility staff with care management and regulatory standards in Behavioral Health . + Participate in care planning by supporting emotional and ... psychological needs of the residents. + Conduct utilization reviews, providing and summarizing clinical information to supervisors...Referral Management of all potential Admissions with Behavioral Health concerns including but not limited… more
- Elevance Health (Sevierville, TN)
- … under the CFSP Care Management model, including coordination across physical health , behavioral health , I/DD, LTSS, pharmacy, and unmet health ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_ _Disabilities (I/DD)… more
- Elevance Health (Nashville, TN)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... **Medical Director-Pain Management /Anesthesia Appeals** **Location:** This role enables associates to...is responsible for the review of appeals for physical health medical services, to ensure the appropriate and most… more
- Elevance Health (Nashville, TN)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
Recent Jobs
-
Level 1 NOC Analyst
- Custom Computer Specialists (Hauppauge, NY)
-
Assistant Nurse Manager General Surgery Minimally Invasive
- BJC HealthCare (St. Louis, MO)
-
Corrosion Specialist
- ONEOK, Inc (Midland, TX)
-
Classified Cyber Sec Asc Mgr
- Lockheed Martin (Little Rock Air Force Base, AR)