- Molina Healthcare (Boise, ID)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- Highmark Health (Boise, ID)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Highmark Health (Boise, ID)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- St. Luke's Health System (Meridian, ID)
- **Overview** At St. Luke's, our dedicated team of Behavioral Health and Case Management professionals strive to build a positive, supportive, and inclusive ... management and care continuum in our Meridian, Nampa, and Fruitland population health areas. **Qualifications:** + Education: Bachelors degree + Preferred degree in … more
- CenterWell (Boise, ID)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- Veterans Affairs, Veterans Health Administration (Boise, ID)
- …completion of clinical reminders As needed, may provide other levels of behavioral health interventions, include case management or care management. Serves ... professional advice and consultation in areas related to professional psychology and behavioral health . 3. Knowledge of clinical research literature. Physical… more
- Magellan Health Services (Boise, ID)
- …* Participates in complex case rounds and/or meetings and consults with Physician Adviser/ Medical Director on regular basis concerning the progress of members. ... Monitors residential level of care services related to mental health and substance abuse treatment to ensure medical...RN. Minimum 2 years experience post degree in healthcare, behavioral health , psychiatric and/or substance abuse … more
- Humana (Boise, ID)
- …make an impact** **Reporting Relationship:** This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with ... community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and… more
- Idaho Division of Human Resources (Boise, ID)
- …Works closely with the Director on a daily basis. + May represent the Director on the Behavioral Health Cooperative, Juvenile Training Council, the Idaho ... and federal funds administration, statewide community operations, project management, community-based behavioral health services, and POST Academy training and… more
- Sevita (Boise, ID)
- …+ Prepare for medical meetings - gather all paperwork as needed for Medical Director , including vital signs, medication lists, all lab work, and other ... orders, appointments, etc. + Set up and break down medical charts at admit/discharge; file forms in chart and...fax information, and communicate information to charge nurse and Director of Nursing Assist Administration Team as needed when… more
- HCA Healthcare (Caldwell, ID)
- …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 ... Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...and patient communication. + You will consult with Program Director and Rehab Physician/ Medical Director … more
- Evolent (Boise, ID)
- …as required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted ... 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,… more
- HCA Healthcare (Caldwell, ID)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed ... an exciting opportunity for you to join West Valley Medical Center which is part of the nation's leading...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Molina Healthcare (Meridian, ID)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... from authorization requests or for additional information as requested by the Medical Director . **Job Qualifications** **Required Education** HS Diploma or GED… more