- Humana (Cincinnati, OH)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Molina Healthcare (Cincinnati, OH)
- …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 (Cincinnati, OH)
- …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
- Bon Secours Mercy Health (Batavia, OH)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more
- Elevance Health (Cincinnati, OH)
- **Provider Relationship Account Manager** Carelon Behavioral Health _Location: Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...Beacon Health Options, offers superior clinical mental health and substance use disorder management , a… more
- Elevance Health (Cincinnati, OH)
- …chronically ill patients, chronically ill pediatric patients, and patients with IDD. + Home Health , Utilization Management or Case Management experience ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more
- Elevance Health (Mason, OH)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For… more
- Elevance Health (Mason, OH)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... and overseeing clinical/non-clinical activities. Will also be responsible for utilization review/ management . May be responsible for developing and… more
- Molina Healthcare (Cincinnati, OH)
- …of OHIO. The Care Review Clinician will provide prior authorization for OH Medicaid behavioral health population. Experience in Behavioral Health ... use disorders and familiarity with ASAM criteria. Familiarity with utilization management and experience using MCG, PEGA....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members… more
- Molina Healthcare (Cincinnati, OH)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… more
- Premier Health (Middletown, OH)
- THERAPIST LSW/LPC, LISW/LPCC & ASSOCIATE FACILITY: SAMARITAN BEHAVIORAL HEALTH The Therapist III functions as a member of a team to assist in the planning, ... standards for administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate knowledge of other… more
- Molina Healthcare (Cincinnati, OH)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be given to those whose… more