- Highmark Health (Frankfort, KY)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CVS Health (Frankfort, KY)
- …to bring accessible healthcare to our members. Aetna is recruiting for an Executive Director , Supporting Kentucky Youth (SKY) who is a key member of the Aetna Better ... managers, quality of care staff, and provider relations staff. This Executive Director is responsible for developing and nurturing relationships with SKY and health… more
- Cognizant (Frankfort, KY)
- **Title: Director , Strategic Product Management (Life Sciences Products & Platform)** **Location: Remote ** **Job ID: 00061957061** **Build a Meaningful Career ... to meet revenue targets as well as develop partnerships. **Job Title: Director , Strategic Product Management (Life Sciences Products & Platform)** **Role: People… more
- Centene Corporation (Frankfort, KY)
- …on best practice models and utilization management processes + Interact with the Medical Director , or designee, to discuss clinical authorization questions and ... 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national...behavioral health care? Centene is looking for a Remote Psychologist to support our Kentucky Medicaid plan. In… more
- Centene Corporation (Frankfort, KY)
- …on best practice models and utilization management processes. + Interact with the Medical Director , or designee, to discuss clinical authorization questions and ... evidence-based behavioral health care.** **Why Join Us?** + **100% remote flexibility** + **Meaningful work impacting care for individuals with Autism** +… more
- Humana (Frankfort, KY)
- …regulations and accreditation bodies. The Manager will report directly to the Associate Director and play a key role in promoting quality improvements, fostering a ... role overseeing clinical teams. + Familiarity with both physical and behavioral health services. + Experience in process improvement- Six Sigma/Lean Concepts.… more
- HCA Healthcare (Bowling Green, KY)
- …incredible team members over the course of three years. **This is a remote /work from home position.** **Sign-On Bonus Eligible* Flexible Schedule! Full-time 40 Hour ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- Molina Healthcare (KY)
- **_ Remote and must live in the United States _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the ... but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. **Job Duties** This role negotiates contracts with the… more