- Humana (Concord, NH)
- …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 (Concord, NH)
- …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
- Centene Corporation (Bedford, NH)
- …and case management activities **Education/Experience:** Master's in Social Work / Behavioral health . 5+ years of experience in managed care, utilization ... for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offering… more
- CenterWell (Concord, NH)
- …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 (Concord, NH)
- …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
- Covenant Health (Nashua, NH)
- …Case Manager works closely with, and delegates care to, the High-Risk Social Worker/ Behavioral Health Clinician because of assessment and determination of social ... to receive services. + Delegates cases to High-Risk Social Worker/ Behavioral Health Clinician based on assessment including...of five years broad clinical experience preferred + Case management and/or Utilization Management experience… more
- Highmark Health (Concord, NH)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of...0 - 1 year of experience working in the Health Insurance Industry **LICENSES AND CERTIFICATIONS** **Required** + None… more
- Beth Israel Lahey Health (Lawrence, MA)
- …a difference in people's lives.** Clinical Supervisor (LICSW / LMHC) - Community Behavioral Health Center located in Lawrence, MA. **Job Description:** + **Sign ... of the Urgent Care/Mobile Crisis Program, including the appropriate utilization and management of staff and quality...Medicaid and non-Medicaid services. Ensures smooth access to MassHealth behavioral health services in the area by… more
- Highmark Health (Concord, NH)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job implements and maintains state-of-the-art procurement, payables , sourcing, or ... performance and compliance monitoring. This position will continuously engage Procurement Management to review performance and key performance indicators and take a… more
- Highmark Health (Concord, NH)
- **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
- Highmark Health (Concord, NH)
- …contribute to highest levels of performance. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but limited to: involved in hiring and ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct, and control… more
- CenterWell (Concord, NH)
- … 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 (Concord, NH)
- …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
- State of Massachusetts (Lawrence, MA)
- …requirements and regulations. . Participates in regular quality improvement and utilization management activities consistent with CBFS policy and practice. ... The Department of Mental Health (DMH) state operated program Respite and High...psychoeducation and skills training in areas such psychiatric illness management ; symptom reduction; dialectical behavioral support; trauma-informed… more
- Sharecare, Inc. (Concord, NH)
- …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 (Concord, NH)
- …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
- HCA Healthcare (Derry, NH)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... **Parkland Medical Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- Marriott (Concord, NH)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... 6 - 10 years' experience with Oracle Human Capital Management (HCM). + 2 to 5 years of experience...for both senior leadership and project teams in effective utilization of existing technology in business technical applications, either… more
- CenterWell (Concord, NH)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... **Become a part of our caring community and help us put health first** The Patient Assessment and Navigation Professional oversees the enrollment, education,… more
- The Home for Little Wanderers (Windsor, NH)
- …distribution and triaging medical issues including direct administration of first aid, management of ongoing medical issues, and determining necessity of the ... utilization of urgent care or emergency room services. Camp...therapeutic summer camp serving youth with social, emotional, and behavioral challenges. Nurses work under the supervision of the… more