- Somatus (Antioch, TN)
- …Records) systems + Minimum three (3) years working with patients with chronic and/or behavioral health needs Ability to be credentialed in local hospital system. ... **Showing Up for You** We offer more than 25 Health , Growth, and Wealth Work Perks to help teammates...leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as… more
- Lincoln Financial (Nashville, TN)
- …including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health case management ... **The Role at a Glance** We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization. As a Behavioral … more
- Elevance Health (Nashville, TN)
- ** Behavioral Health Care Manager II -...is licensed staff supervision. + Previous experience in case management / utilization management with a broad ... law._ **Shift & Hours:** Monday - Friday, 8:00AM-5:00PM The ** Behavioral Health Care Manager II - Licensed...as well as independently strongly preferred. + Effective time management skills are strongly preferred. For URAC accredited areas,… more
- Elevance Health (Nashville, TN)
- …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 ... **JR167284 Behavioral Health Clinical Quality Audit Analyst, Sr** Responsible for maintaining crisis accreditation and developing, delivering and evaluating… more
- BlueCross BlueShield of Tennessee (Murfreesboro, TN)
- The Behavioral Health Case Manager for Transitions of Care is dedicated to proactive engagement with members admitted to Acute Inpatient Psychiatric facilities\. ... This role involves coordinating care to address immediate behavioral health needs and overcoming barriers to discharge from inpatient care\. The goal is to… more
- Highmark Health (Nashville, TN)
- …:** **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
- Highmark Health (Nashville, TN)
- …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...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Highmark Health (Nashville, TN)
- …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
- Elevance Health (Murfreesboro, TN)
- …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
- Elevance Health (Murfreesboro, TN)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and accurate… more
- HCA Healthcare (Nashville, TN)
- …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 ... within the group(s), including staffing, maintenance, repairs, parts, operations, fleet management and vendor/contractor utilization . + Responsible for the… more
- HCA Healthcare (Nashville, TN)
- …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 ... organization that invests in you as a Director Case Management ? At TriStar Skyline Medical Center, you come first....Center offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Nashville, TN)
- …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 ... have the career opportunities as a Manager Enterprise Content Management Solutions you want with your current employer? We...Healthcare offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Nashville, TN)
- …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 ... career opportunities as a Regional Sales Trainer - Home Health you want with your current employer? We have...materials accordingly. 9. Work with the Operational and Clinical management team to develop approach, scope and methodology of… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job plays a key role in ensuring projects (ie change initiatives) meet objectives on time ... and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the… more
- Elevance Health (Murfreesboro, TN)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current needs… more
- Elevance Health (Nashville, TN)
- … health care program in which members needs are identified, including physical health , behavioral health , social services for a special product/programs. ... **How you will make an impact:** + Manages resource utilization to ensure appropriate delivery of care to members,...in applicable state(s) required. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
- HCA Healthcare (Nashville, TN)
- …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 ... Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with… more
- Highmark Health (Nashville, TN)
- …within the Scrum Master and PO CoE teams through coaching, performance management , and fostering collaboration. The manager provides **oversight for Scrum Masters** ... **leading the Agile Transformation** , including strategic planning, change management , stakeholder engagement, tracking transformation metrics, and fostering continuous… more
