- Commonwealth Care Alliance (Boston, MA)
- … Mgmt - Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. - Ensures that utilization management processes are integrated with care management … more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. - Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - No, this… more
- Commonwealth Care Alliance (Boston, MA)
- … Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. * Ensures that utilization management processes are integrated with care management … more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: * No, this… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... and appropriately identify and refer requests to the Medical Director when indicated. The BH UM Reviewers...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
- East Boston Neighborhood Health Center (MA)
- …policies, procedures, and patient education materials in collaboration with the Medical Director (s). 3.Facilitates in collaboration with the BH Leadership Team ... Epic training team as indicated. 4.In collaboration with the BH Medical Director , designs and implements the...Specialty, and all other clinical programs assigned. 18.Provides programmatic management and oversight of access and utilization … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Molina Healthcare (UT)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management ...and financial goals across all LOBs * Responds to BH -related RFP sections and review BH portions… more
- Humana (Indianapolis, IN)
- … management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. ... delivery model. **Position Responsibilities:** + Leads clinical and quality management components of Humana's BH services +...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …Accountabilities: Level I + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
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