- Centene Corporation (Madison, WI)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Elevance Health (Waukesha, WI)
- ** Behavioral Health Medical Director - Psychiatrist** Location: Alternate locations may be considered. This position will work a hybrid model ( remote and ... within 50 miles of an Elevance Health Pulse Point location. The ** Behavioral Health Medical Director - Psychiatrist** is responsible for completing medical… more
- Elevance Health (Waukesha, WI)
- ** Behavioral Health Medical Director - Child Psychiatrist** Location: Alternate locations may be considered. This position will work a hybrid model ( remote ... Fulltime position, Monday through Friday. Open to part-time. The ** Behavioral Health Medical Director - Child Psychiatrist** is responsible for completing… more
- Highmark Health (Madison, WI)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Waukesha, WI)
- **Medicare Medical Director ** Location: **Hybrid 2:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, ... able to work Eastern Time Zone hours. The **Medicare Medical Director ** is responsible for the administration...** is responsible for the administration of physical and/or behavioral health medical services, to ensure the… more
- Molina Healthcare (Racine, WI)
- …from authorization requests or for additional information as requested by the Medical Director . **Job Qualifications** **Required Education** HS Diploma or GED ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- Humana (Madison, WI)
- …**Reporting Relationship:** This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with Florida licensure or ... community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to… more
- Evolent (Madison, WI)
- …required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted via ... also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our... reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs, Clinical Reviewers.… more
- Molina Healthcare (WI)
- **_ Remote and must live in the United States _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the ... but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. **Job Duties** This role negotiates contracts with the… more