- 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
- 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
- Molina Healthcare (Lincoln, NE)
- …**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 (Springfield, IL)
- … 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
- Centene Corporation (Tallahassee, FL)
- …Doctor or Doctor of Osteopathy, Indiana-licensed Geriatrician that assists the Chief Medical Director , Utilization Management , Care Management , and ... functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. +… 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
- MVP Health Care (Rochester, NY)
- …senior leaders to promote appropriate care quality, service utilization , medication utilization and adherence, care management , and cost control. + Through ... improvement. To achieve this, we're looking for a **Medical Director , Behavioral Health Children's Services** , to join #TeamMVP....of five years of experience working with children in BH managed care settings or BH clinical… more
- CVS Health (IL)
- …expertise and oversight to all areas within the clinical services including Care Management , Utilization Management , Population Health, Health Equity and ... each and every day. **Position Summary:** The ABHIL Chief Psychiatrist (Senior Medical Director ) will serve as a strategic and operational partner to the State, CEO,… more
- Elevance Health (Columbus, OH)
- **JR167272 Manager Behavioral Health Services** Responsible for overseeing Behavioral Health Utilization Management ( BH UM), this position supports the ... facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and… more
- CVS Health (Oklahoma City, OK)
- …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... stay and identify any barriers to discharge. + Assist Utilization Management team with access to external...in regular meetings with CVS Health regional leaders, Program Director , Project Manager and other Transitional Care Managers on… more
- CVS Health (MI)
- …expert and provide oversight of the design, development, and deployment of Care Management , Utilization Management , Population Health, Health Equity and ... the needs of members and providers. 3. Coordinate with the Population Health Management Director and provide clinical leadership on population health. 4.… more
- Premier Health (Dayton, OH)
- …standards for administration and reporting of outcome measures and documentation of utilization management of clinical care. Demonstrate knowledge of other ... individual and family therapy services, and some limited case management to young children. Other services to be provided...service agencies. Please feel free to contact YCATS Program Director if you would like more information about this… more
- Premier Health (Dayton, OH)
- …standards for administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate knowledge of ... providers to ensure appropriate client care and continuity of care. . Provides case management and CPST services to coordinate clinical care in the form of face to… more