- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… more
- CenterWell (Providence, RI)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews ... health claims. The Medical Director , Primary Care work assignments involve...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
- Highmark Health (Providence, RI)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- CVS Health (Woonsocket, RI)
- …execution on Aetna's overall strategic plan, roadmap, and investment areas for its behavioral health and employee assistance businesses. This role reports to the ... At CVS Health , we're building a world of health...heart, each and every day. **Position Summary** The Lead Director , Mental Well-being Strategy is responsible for leading the… more
- Highmark Health (Providence, RI)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Analytics, Contracting, Market and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- Magellan Health Services (Newport, RI)
- …child daycare centers and schools, and consultation to installation command regarding behavioral health issues affecting military personnel and their family ... - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health , Master's - Social Work Education - Preferred License and… more
- Charter Care Health Partners (Providence, RI)
- …Under the direction of the System Director of Outpatient and Integrated Behavioral Health , ED Clinicians will function as clinical Behavioral ... of care. Clinician will have working knowledge of insurance prior authorization, medical necessity criteria and ASAM criteria. Clinicians will have the ability to… more
- South County Hospital (Wakefield, RI)
- …with the case management department, complex care medical social worker, community health team, family home visiting and other behavioral health ... during, and after discharge or transfers. The social worker will provide behavioral health /substance abuse treatment options, by securing inpatient facility… more