- Humana (Annapolis, MD)
- …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 (Washington, DC)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in ... clinically appropriate treatment, evidence based care an clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. +… more
- Immigration and Customs Enforcement (Washington, DC)
- …Perform other duties and responsibilities as assigned. 16. Utilization review/ management for inpatient behavioral health hospitalization for IHSC. ... Summary The Behavioral Health Case Manager is a...case coordination/ management , monitoring high risk individuals, independent behavioral health reviews, behavioral … more
- AmeriHealth Caritas (Washington, DC)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity...for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring… more
- CenterWell (Washington, DC)
- …+ 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
- Elevance Health (Hanover, MD)
- …required. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience strongly preferred. + Inpatient mental health experience ... ** Behavioral Health - Care Manager II**...** Behavioral Health - Care Manager II** **Location** : _Virtual:_...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Humana (Washington, DC)
- …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
- Adecco US, Inc. (Dulles, VA)
- **Position Title:** Nurse Manager - Behavioral Health **Location:** 24440 Stone Springs Blvd, Dulles, VA 20166 **Facility:** StoneSprings Hospital Center ... fostering collaboration, compassion, and excellence in care. The Nurse Manager - Behavioral Health oversees the day-to-day operations of the Behavioral… more
- Highmark Health (Washington, DC)
- …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 (Washington, DC)
- …:** **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