- Humana (Frankfort, KY)
- …Influences and assists corporate leadership in strategic planning to improve effectiveness of behavioral health utilization management programs. + ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health ) who will utilize their clinical… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Elevance Health (Lexington, KY)
- **A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Humana (Frankfort, KY)
- …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
- CenterWell (Frankfort, KY)
- …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
- Universal Health Services (Lexington, KY)
- …Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. ... treatment through treatment planning, the treatment team process, and utilization review. Follows and abides by company policies, procedures,...to meet the needs of our community. The Ridge Behavioral Health System is a 110-bed hospital… more
- Highmark Health (Frankfort, KY)
- …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
- Humana (Frankfort, KY)
- …experience leading teams focusing on quality management , utilization management , discharge planning and/or home health or rehab. + Strategic thinking ... the senior population with a strong lens on intersecting behavioral and social health needs. + Provide...management , utilization management , case management , discharge planning and/or home health or… more
- CVS Health (Frankfort, KY)
- …other key personnel. + Updates the Care Plan for any change in condition or behavioral health status. Our TOC Coaches are frontline advocates for members who ... Medication management , Community Resources and supports) + Evaluation of health and social indicators + Identifies and engages barriers to achieving optimal… more
- Universal Health Services (Lexington, KY)
- …Counseling, as well as Medication Management for all ages. We have provided behavioral health services to over 92 Kentucky counties for more than 39 years. ... to meet the needs of our community. The Ridge Behavioral Health System is a 110-bed hospital...to appropriate agencies, in conjunction with Business Office and Utilization Review. What We Offer You: + Challenging and… more
- HCA Healthcare (Lexington, KY)
- …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 ... + **Supervises, monitors, and ensures competencies and performance of assigned home health care team(s)** + **Supervises ongoing case management of all… more
- Highmark Health (Frankfort, KY)
- **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 (Frankfort, KY)
- …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 (Frankfort, KY)
- … 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
- Humana (Frankfort, KY)
- …+ Administer new innovative VBP models for range of provider types, such as behavioral health , maternity, specialists, and social determinants of health , ... **Become a part of our caring community and help us put health first** The Sr. Value-Based Programs professional supports successful value-based provider… more
- CenterWell (Frankfort, KY)
- …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
- Marriott (Frankfort, KY)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... + Experience in waterfall and/or agile software methodologies + Vendor management experience **Preferred Qualifications:** + Graduate degree + Oracle Global Human… more