• Manager, Utilization Management

    Humana (Frankfort, KY)
    management criteria including ASAM. + Leads development of utilization management policies and procedures to ensure compliance with state and federal ... Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize...an impact** **Required Qualifications** + An active, unrestricted Virginia Registered Nurse ( RN ) or Behavioral… more
    Humana (05/30/24)
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  • Manager, Care Management (Ltss/ABD)

    Humana (Frankfort, KY)
    …_(Washington DC, MD, WV, KY, TN & NC)_ **.** + An active, unrestricted, Registered Nurse ( RN ) license or Licensed Mental Health Professional (LMHP) ... services, social sciences, or health related field. + Previous experience in utilization management , discharge planning and/or home health or rehabilitation. +… more
    Humana (05/13/24)
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  • Associate Director, Care Management

    Humana (Frankfort, KY)
    …_(Washington DC, MD, WV, KY, TN & NC)_ **.** + An active, unrestricted, Registered Nurse ( RN ) license or Licensed Mental Health Professional (LMHP) ... with mandated and corporate policies regarding other departmental areas such as medical management , utilization management , population health and quality. +… more
    Humana (05/13/24)
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  • Manager, Service Coordination (Virginia Medicaid)

    Humana (Frankfort, KY)
    …health-related field. + Care Management certification (CCM). + Active, unrestricted, Registered Nurse ( RN ) license or Licensed Mental Health Professional ... in analyzing and interpreting financial trends. + Previous experience in utilization management , discharge planning and/or home health or rehabilitation.… more
    Humana (05/13/24)
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  • Assessment Clinician

    Universal Health Services (Lexington, KY)
    …or Human Services field, with at least two years crisis experience; Registered Nurse ; LCSW/LPCC/LMFT preferred. Experience + Prior intake, assessment, admission ... Hospitalization, Intensive Outpatient Programs, Individual Counseling, as well as Medication Management for all ages. We have provided behavioral health services to… more
    Universal Health Services (05/19/24)
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  • Clinical Strategy and Practice Lead, Pharmacy Home…

    CenterWell (Frankfort, KY)
    …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... patient care policy manuals. + Establish service policies and procedures in compliance with state health statutes and administrative rules, including CDC and OSHA… more
    CenterWell (05/08/24)
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