- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …a member's benefit coverage while working remotely. Primary Responsibilities * Performs behavioral health clinical utilization reviews using evidenced based ... About The Role BHPS provides Utilization Management services to its clients....* Experience with both inpatient and outpatient reviews for Behavioral Health (examples: TMS, ECT, ABA, Psychotherapy,… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Durham, NC)
- …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... medical director provides clinical expertise in all aspects of utilization review and case management . Provides input...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- UNC Health Care (Morrisville, NC)
- …of patients based on various factors such as medical conditions, social determinants of health , and behavioral health needs. b. Develop strategies to ... **Description** UNC Health Alliance is UNC Health 's statewide...Payer Communication: a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and… more
- Elevance Health (Durham, NC)
- … Health OP services. + Mentors Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and ... will make an impact:** + Partners with internal UR staff and external Behavioral Health Providers to ensure appropriate and consistent utilization of plan… more
- UNC Health Care (Chapel Hill, NC)
- …of patients based on various factors such as medical conditions, social determinants of health , and behavioral health needs. b. Develop strategies to ... 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely… more
- UNC Health Care (Chapel Hill, NC)
- …inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: A Social Worker ... This includes assessing their support systems, coping mechanisms, mental health conditions, and psychosocial factors. 2. Patient-Centered Care Plans: Collaborate… more
- Elevance Health (Durham, NC)
- …Capabilities, and Experiences:** + PharmD highly preferred + Experience with behavioral health and psychiatric conditions/medications for children and adults, ... of an Extraordinary Team** CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By… more
- City of Durham (Durham, NC)
- …meet the needs of people in crisis with compassionate care and behavioral health expertise. Interested applicants can visit our website ... Familiarity with Durham health systems and community resources/services for physical health behavioral and mental health , substance use, Intellectual… more
- City of Durham (Durham, NC)
- …meet the needs of people in crisis with compassionate care and behavioral health expertise. (Interested applicants can visit our website ... Service Definitions, ie ACT, CST IOP, SACOT, Innovation Wavier), utilization review, and data management . + Knowledge... health systems and community resources/services for physical health behavioral and mental health ,… more
- General Dynamics Information Technology (Fort Bragg, NC)
- …**Job Family:** Healthcare Services **Skills:** Clinical Research,Confidentiality,Consultation,Mental Health ,Researching **Experience:** 2 + years of related ... various tests. Records data in/on appropriate files, records, and/or electronic health records. Complete all documentation on healthcare encounters within 72… more
- General Dynamics Information Technology (Fort Bragg, NC)
- …None **Job Family:** Healthcare Services **Skills:** Cognitive Training, Health Outcomes,Human Performance,Researching,Special Operations **Experience:** 3 + years ... personnel individually and in groups in evidence-based cognitive and behavioral strategies, including attention and concentration, problem-solving, emotional regulation,… more