- Humana (Indianapolis, IN)
- …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
- Elevance Health (Indianapolis, IN)
- …role in a managed care environment and possess strong utilization management experience. + ** Behavioral Health & Chemical Dependency:** Substantial ... Behavioral Health offers superior clinical mental health and substance use disorder management , a...GA, Woodland Hills, CA. **Summary** The Behavioral Health Chief Medical Officer oversees Utilization Review,… more
- Humana (Indianapolis, IN)
- …Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health ; MED-Deeming accreditation standards ... degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management...knowledge is a plus. + Registered Nurse or Behavioral Health Licensed Professional. + Managed care,… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Evolent (Indianapolis, IN)
- …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
- Community Health Network (Indianapolis, IN)
- …and facilitates trainings on specific bio-psychosocial approaches for the team. Assists with management of urgent behavioral health needs with medical ... Behavioral Health Consultant- LCSW, LMHC, or...required. - 2 + years of experience providing mental health treatment required. - Utilization of conventional… more
- Community Health Network (Indianapolis, IN)
- Behavioral Health Therapist Acute- North Job Ref 2502755 Category Behavioral Health Job Family Behavioral Health Therapist, Licensed Department ... Social Svcs Behavioral Health Schedule Part-time Facility Behavioral ...Care Services policies and procedures. Participate in Aggressive Behavior Management appropriate to the population served. See Behavioral… more
- Elevance Health (Indianapolis, IN)
- ** Behavioral Health Medical Director- Psychiatrist** Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). ... 50 miles of an Elevance Health Pulse Point location. The ** Behavioral Health Medical Director- Psychiatrist** is responsible for completing medical necessity… more
- Ascension Health (Indianapolis, IN)
- …to hire date or job transfer date. + Social Worker credentialed from the Indiana Behavioral Health and Human Services Licensing Board obtained prior to hire date ... areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise assignments daily to… more
- Highmark Health (Indianapolis, IN)
- …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
- Highmark Health (Indianapolis, IN)
- …timeframes and notification requirements are met + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care,...and management + Route Cases Based on Established Guidelines +… more
- Liberty Healthcare Corporation (Indianapolis, IN)
- Behavioral health professionals are encouraged to consider an outstanding career opportunity with Liberty Behavioral Health Corporation. A full-time ... is available with Liberty and the Indiana Sex Offender Management and Monitoring Program. The mission of the Indiana...to help a significant number of people improve their behavioral health , prevent sexual abuse and victimization,… more
- Elevance Health (Indianapolis, IN)
- …such as coordination and management of an individual's waiver (such as LTSS/IDD), behavioral health or physical health needs. + Submits utilization ... in which a risk is identified related to the members LTSS, physical or behavioral health supports (including, but not limited to, potential for high-risk… more
- Elevance Health (Indianapolis, IN)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
- Highmark Health (Indianapolis, IN)
- …(Claims, Dental Benefits, Customer Service, Membership & Billing), Provider Data Management , Underwriting, and Professional Relations. **This role will support the ... including gathering data from multiple sources related to Benefit/Claim Utilization , Enrollment, Networks ( utilization , disruption, geo-access) and making… more
- Community Health Network (Indianapolis, IN)
- Social Work- Lic MSW- South Job Ref 2502322 Category Behavioral Health Job Family Social Worker Department Medical Oncology Schedule Full-time Facility Cancer ... Care Services policies and procedures. - Participates in Aggressive Behavior Management appropriate to the population served. See Behavioral Care Services… more
- Elevance Health (Indianapolis, IN)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... engagement. The **RN Case Manager** is responsible for overall management of member's case within the scope of licensure;...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a… more
- Community Health Network (Indianapolis, IN)
- Social Worker Lic MSW- HATS Geriatrics- East/South Job Ref 2500953 Category Behavioral Health Job Family Social Worker Department Touchpoint HATS Schedule ... Care Services policies and procedures. - Participates in Aggressive Behavior Management appropriate to the population served. See Behavioral Care Services… more
- Elevance Health (Indianapolis, IN)
- …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
- Highmark Health (Indianapolis, IN)
- …:** **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