- CVS Health (Frankfort, KY)
- …or alternative care setting such as ambulatory care or outpatient clinic/facility. Unencumbered Behavioral Health clinical license in the state where they work. ... external constituents in the coordination and administration of the utilization /benefit management function Required Qualifications 3 years...LMSW, LSW, LISW, LMFT, LMHC, LCSW) OR RN with behavioral health experience required. Must be able… more
- Humana (Frankfort, KY)
- …such as provider relations, claims submission and payment, utilization management processes, behavioral health processes, and dispute resolution. ... part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Senior...educational material, or trainings. + 2+ years of project management experience with mid-size projects. + 1+ years of… more
- CVS Health (Frankfort, KY)
- …/benefit management program. Required Qualifications : + Licensed independent Behavioral Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT ... + Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to multitask, prioritize and… more
- Conviva (Frankfort, KY)
- …to others. Preferred Locations: Daytona, FL, Louisville, KY, San Antonio, TX The Utilization Management Nurse utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently… more
- Humana (Frankfort, KY)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such as ... part of our caring community and help us put health first** The Behavioral Health ...health insurance, other healthcare providers, clinical group practice management . + Utilization management experience… more
- Humana (Frankfort, KY)
- …put health first** This is a non-exempt position with responsibility for utilization management and clinical decision-making as outlined in the Autism Care ... and receives guidance where needed. Follows established guidelines / procedures, utilizes behavioral health knowledge and skills to support the coordination,… more
- Humana (Frankfort, KY)
- …resolve basic technical difficulties in a remote environment. **Preferred Qualifications** + BSN + Behavioral Health Utilization Management + Health ... us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and… more
- CVS Health (Frankfort, KY)
- …for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... on interventions to improve outcomes. Required Qualifications * 2 years' experience in behavioral health , social services, or human services field.* 1 year… more
- CenterWell (Frankfort, KY)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… more
- Highmark Health (Frankfort, KY)
- …account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case/ disease management ... information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a...review. + Assist in the development and implementation of utilization management programs including but not limited… more
- CVS Health (Frankfort, KY)
- …care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Universal Health Services (Lexington, KY)
- …Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. ... to meet the needs of our community. The Ridge Behavioral Health System is a 110-bed hospital...treatment through treatment planning, the treatment team process, and utilization and review. + Conduct psychosocial assessments. + Assess,… more
- Highmark Health (Frankfort, KY)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job supports the retention of existing accounts and the acquisition of new members/contracts ... and Sales leadership to present and prepare data analyses, pharmacy management strategies and pharmacy capabilities to Organization clients and potential clients.… more
- CenterWell (Frankfort, KY)
- … and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management , care management , clinical information ... directly address the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative...well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up… more
- Highmark Health (Frankfort, KY)
- …software engineers as needed on ETO Digital team. + Comprehension and utilization of the newest, emerging, innovative technologies and applications + Apply lead ... best practices, including coding standards, code reviews, source control management , build processes, testing, and operations. + Expected to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Sharecare, Inc. (Frankfort, KY)
- …of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. ... team. Facilitates communication exchange with primary managing physician and other providers, health plan, and the disease management program team. + Coordinates… more
- CenterWell (Frankfort, KY)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... leader will play a critical role in ensuring optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and… more
- Marriott (Frankfort, KY)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... Qualifications:** + 8+ years of experience in data strategy, data management , data preparation supporting Oracle on premise or cloud analytics applications.… more
- Marriott (Frankfort, KY)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management Marriott has an exciting opportunity for a Senior Software ... SOA Suite, or AWS Integration Services + Hands on experience with API Management , API Gateways, Messaging Services, Event Bus and Workflow tools + Proficiency in… more