- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... action. + Minimum one, (1) year of experience in Behavioral Health Nursing (inpatient outpatient, psych, substance...Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan… more
- Centene Corporation (Austin, TX)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- CenterWell (Austin, TX)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... 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… more
- Molina Healthcare (Austin, TX)
- …equivalent experience * 2 or more years in case, disease, or utilization management ; managed care; or medical/ behavioral health settings. * Proficient in ... development, implementation, and collaboration with the delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. **Job… more
- Molina Healthcare (Austin, TX)
- …with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and... Health function provides leadership and guidance for utilization management and case management … more
- CVS Health (Austin, TX)
- …members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical ... judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health , psychosocial wrap around services. The care manager will… more
- CVS Health (Austin, TX)
- …members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical ... judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health , psychosocial wrap around services. + The care manager… more
- CenterWell (Austin, TX)
- …engagement, improving provider capacity by reducing administrative work related to population health management , and assisting patients with the aim of improving ... advocate for improving clinician and patient experience and effectiveness through panel management (aka population health management ) + Comfortable managing… more
- CVS Health (Austin, TX)
- …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
- Highmark Health (Austin, TX)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- … Health Institute is a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position ... insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. +...Luck & we hope to meet you soon! Georgetown Behavioral Health Institute is an equal opportunity… more
- Highmark Health (Austin, TX)
- …Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Austin, TX)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- HCA Healthcare (Austin, TX)
- …+ Uses available tools to identify at-risk patients + Refers patients for medical and/or behavioral health care management , as needed + Documents efforts in ... empanelment processes + Schedules appointments related to preventive care, chronic disease management , and/or integrated behavioral health + Prepares and… more
- Highmark Health (Austin, TX)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job will manage small scale projects and enhancement packages with mentorship and leadership ... from more senior Delivery Owners. The incumbent provides project management leadership and facilitates the delivery of system changes from approval through to… more
- Centene Corporation (Austin, TX)
- …Experience with ABA, Psychological Testing, Neuropsychological Testing required. Utilization Management experience strongly preferred. **Position Purpose:** ... Authorize, direct and monitor care for behavioral health and substance abuse problems according...practitioners to provide education on best practice models and utilization management processes + Interact with the… more
- Highmark Health (Austin, TX)
- …portfolio of AI-powered products, including a core administrative platform, modular utilization and care management solutions, patient-focused digital products, ... Marketing qualified leads and sales qualified leads. + Opportunity Pipeline Management : Manage and forecast the sales pipeline, providing accurate revenue… more
- Highmark Health (Austin, TX)
- …familiarity with key domains like CMS interoperability, Quality management , care & utilization management , and digital health + 3 years' experience in ... brand visibility, market intelligence, etc.) + Proposal & RFP Management : + Support proposal development timelines, coordinate input across...from lead to closure) + 3 years' experience in Health Plan Technology + 3 years' experience with solid… more
- Centene Corporation (Austin, TX)
- …you a licensed Psychologist in Oklahoma with a passion for improving access to behavioral health care? Centene is looking for a Remote Psychologist to support ... appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds.** **We're seeking candidates who:** +… more