- MetroPlusHealth (New York, NY)
- …work with us. You can come to work being proud of what you do every day.The Behavioral Health Utilization Management (BH UM) Clinician is responsible for ... activities in accordance with New York State and MetroPlusHealth Utilization Management policies and procedures. The position responsibilities include… more
- MetroPlusHealth (New York, NY)
- … Home, primary caregiver, the primary and attending physicians, and various Behavioral Health and/or Substance Use Disorder providers. In partnership with ... responsible for scheduling aftercare follow-up for members discharging from an acute behavioral health inpatient setting. This position ensures that members have… more
- MetroPlusHealth (New York, NY)
- …trends to ensue formulary appropriateness Administers and manages all pharmacy case management programs, including the Behavioral Health Pharmacy Program ... Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If...for identifying criteria and medications to continuously improve drug utilization management strategies for the pharmacy and… more
- MetroPlusHealth (New York, NY)
- …of an evidence-informed, individualized Plan of Care that addresses their complex medical, behavioral health and social service needs. This position may be ... other MetroPlusHealth departments with resolution of member concerns related to retention, utilization management , quality management , customer service, and… more
- Molina Healthcare (Yonkers, NY)
- …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
- Molina Healthcare (Yonkers, NY)
- …licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/ behavioral health settings. + One year of ... Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care Quality,… more
- BriteLife Recovery (Englewood, NJ)
- …in utilization review, case management , or insurance coordination in a behavioral health or substance use treatment setting. + Knowledge of ASAM criteria ... and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? +...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- MVP Health Care (Tarrytown, NY)
- …and continuous improvement. To achieve this, we're looking for a **Medical Director, Behavioral Health Children's Services** , to join #TeamMVP. If you have ... reviews. Lead's MVP's efforts to collaborate in person and virtually with behavioral health network providers and facilities around clinical determinations,… more
- CVS Health (Passaic, NJ)
- …members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical ... judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health , psychosocial wrap around services. The care manager will… more
- Molina Healthcare (Yonkers, NY)
- …with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and... Health function provides leadership and guidance for utilization management and case management … more
- Atlantic Health System (Morristown, NJ)
- …and families on diagnoses, treatment options, relapse prevention, and self- management strategies. 04. Provides brief, evidence-based behavioral interventions ... communication. 02. Screens, assesses, and monitors patients for common mental health and substance use disorders. Facilitates patient engagement and follow-up care.… more
- Molina Healthcare (Yonkers, NY)
- …**_Field travel in Detroit, MI_** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management ... health and substance use services and assists with implementing integrated Behavioral Health care management programs. **Job Duties** * Serves as liaison… more
- CVS Health (Newark, NJ)
- …members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , clinical ... judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health , psychosocial wrap around services. The care manager will… more
- The Cigna Group (Morris Plains, NJ)
- …by the client + Develop, prepare, and present clinical business strategies (formulary, utilization and/or health management strategy, support for client P&T ... requires the combination of a strong clinical background, deep understanding of utilization management criteria, and ability to read pharmaceutical contracts,… more
- City of New York (New York, NY)
- …data management , stakeholder collaboration, and capacity building to enhance behavioral health services for pregnant and parenting caregivers. Job Duties ... tools. Program Strategy & Service Expansion - Lead the expansion of behavioral health services for pregnant and parenting caregivers, integrating substance… more
- Elevance Health (New York, NY)
- …law._ The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... an equivalent background. * _For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5 years of experience providing … more
- Elevance Health (New York, NY)
- …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
- Atlantic Health System (Summit, NJ)
- …an Advanced Comprehensive Stroke Center. Additional Joint Commission-certified services include behavioral health care, spine surgery, wound care, and primary ... of selected member populations across the continuum of illness. Ensures effective utilization and monitors health care resources. Manages the interdisciplinary… more
- Community Health Action of Staten Island (Staten Island, NY)
- …Transportation Services Staten Island, NY (http://maps.google.com/maps?q=56+Bay+Street+Staten+Island+NY+USA+10301) * Behavioral Health Job Type Part-time, ... Temporary Description Title:Senior Peer Mentor - Transportation Services Department: Behavioral Health Reports To:Transportation Services Coordinator Location:56… more
- BMS Family Health and Wellness Centers (Brooklyn, NY)
- … health and/or human services required and two-years qualifying experience in behavioral health and/or care coordination. + CANS (Children Assessment Needs ... Description You will be responsible for providing intensive care management to chronically ill patients and their families by...and their families by advocating and navigating through the health care system. The Care Manager will promote linkage… more
