- Signet Health (Louisville, KY)
- OverviewSignet Health , a national behavioral health management company, is currently recruiting for a full-time seasoned Nurse Program Director to manage ... services for a 20-bed program at U of L Health , Peace Behavioral Health Hospital...evaluating nursing care and patient outcomes. Responsible for resource management , policy and program development, and fiscal management… 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
- CVS Health (Frankfort, KY)
- …/benefit management program. Required Qualifications : + Licensed independent Behavioral Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT ... + Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to multitask, prioritize and… more
- Elevance Health (Louisville, 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
- Elevance Health (Louisville, KY)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... 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
- 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
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …beliefs and shared management philosophy of the department. The Director of Behavioral Health Nursing assists the Director of Clinical Services - ... of the license. Utilization of critical thinking skills. The Director of Behavioral Health Nursing assists the Director of Clinical Services- Behavioral … more
- Elevance Health (Louisville, KY)
- …responsible for appeals reviews within our Medicaid and Medicare programs.** The ** Behavioral Health Medical Director** is responsible for the administration of ... behavioral health medical services, to ensure the...clinical reviews. + The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and… more
- Universal Health Services (Radcliff, KY)
- Responsibilities Utilization Review Coordinator Opportunity Lincoln Trail Behavioral Health System is a 140-bed hospital offering inpatient services for ... adolescents, adults, military/veterans and their families. Lincoln Trail Behavioral Health System has a spacious cafeteria,...Degree in Social Work or Psychology + Experience in Utilization Management preferred + Current CPR or… more
- CVS Health (Frankfort, KY)
- …for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... on interventions to improve outcomes. Required Qualifications * 2 years' experience in behavioral health , social services, or human services field.* 1 year… more
- BrightSpring Health Services (Louisville, KY)
- … utilization and hospital admission reduction. + Provides survey management support/ follow-up/and coordination of corrective actions plans relatied to care ... home health care, + Three years' experience in an administrative/supervisory/quality management role in a Medicare certified home health agency generally… 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
- CVS Health (Frankfort, KY)
- …care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member's overall wellness. ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Clinical Denials Management and Audit monitors, responds to, and performs the clinical denial and appeal ... provides subject matter expertise around clinical documentation and denials management . They will also support detailed level reporting and...as a nurse + Two years of experience in health care utilization review or home care… 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
- Elevance Health (Louisville, KY)
- …PST.** The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5...a State agency. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is a plus. +… 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
- Universal Health Services (Louisville, KY)
- …Brook Hospital will strive to set the standard for excellence in the field of behavioral health care and will maintain its leadership role by treating each ... is one of the nation's largest and most respected health care management companies, operating through its... companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory care centers… 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
