- MVP Health Care (Rochester, NY)
- …Behavior Analyst (BCBA) preferred. If possessing an LBA, another clinical license is not required. Willingness and ability to obtain equivalent license ... established deadlines. Ability to make independent decisions regarding resource utilization, and quality of care. Must demonstrate understanding of clinical and… more
- Molina Healthcare (Louisville, KY)
- …KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and inpatient services for the OH ... speed required. JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying… more
- UCLA Health (Los Angeles, CA)
- Description The Public Mental Health Partnership (PMHP) is seeking to hire a full-time Clinical Quality Analyst (CQA) to conduct fidelity reviews for ... as a California Center of Excellence (COE) under the BH -CONNECT Initiative. The CQA will conduct fidelity reviews on-site...quality assurance, quality improvement, and/or data-driven quality monitoring processes in clinical settings +… more
- Commonwealth Care Alliance (Boston, MA)
- …Provider Contracting department and will have regular interaction with relevant internal Clinical , Quality , and BI departments, while frequently interfacing with ... for Mental Illness (FUH) data:** + Work with BI, Quality , and BH teams to evaluate and...Network on the measures** + Organize trainings, working with Quality and Clinical teams to build reference… more
- SSM Health (MO)
- …Type:** Regular **Job Highlights:** Exciting Opportunity for an Epic Systems Analyst at SSM Health! Required certifications are EpicCare Ambulatory, Inpatient ... Clinical Documentation, or Procedure Orders. Preferred certifications are Beacon...reports for multiple Epic applications. Tests build to ensure quality delivery to business partners. + Implements and stabilizes… more
- Centene Corporation (Harrisburg, PA)
- …level of care and services are medically appropriate related to behavioral health ( BH ) and/or autism spectrum disorder needs and clinical standards + Performs ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...accordance with ABA regulatory guidelines and criteria + Analyzes BH member data to improve quality and… more
- Centene Corporation (Bedford, NH)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Purpose:** Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams. Assesses and… more
- MVP Health Care (Tarrytown, NY)
- …Board-Certified Behavior Analyst (BCBA) preferred. If possessing an LBA, another clinical license is not required. + Willingness and ability to obtain equivalent ... , and an **Inclusive Workplace** . The Behavioral Health ( BH ) Professional is responsible for conducting utilization review for...quality of care. + Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or… more
- Elevance Health (Costa Mesa, CA)
- …Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental health and substance use disorder management, a comprehensive employee ... an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access...assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in… more
- Elevance Health (Indianapolis, IN)
- …companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive ... for members with behavioral health needs. Subject matter expert in targeted clinical areas of expertise such Autism Spectrum Disorders (ASD). Candidates with BCBA… more
- Elevance Health (Ashburn, VA)
- …you will make an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary ... quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as appropriate.… more
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