- HCA Healthcare (Nashville, TN)
- …intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Behavioral Health Utilization Review RN MSW Parallon. ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Behavioral Health Utilization Review RN MSW for our team to… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a NICU Utilization Review Services RN? At Parallon, you come first. HCA Healthcare has committed ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...a difference. We are looking for a dedicated NICU Utilization Review Services RN like you to… more
- CVS Health (Nashville, TN)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channel + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- **Join Our Team as a Medical Review Director\- Behavioral Health \!** Are you a dedicated and experienced medical professional with a passion for quality ... We are seeking a self\-motivated and detail oriented Medical Review Director to lead our team in ensuring the...board\-certified psychiatrist with management experience in the areas of behavioral health and addiction medicine\. We're looking… more
- Highmark Health (Nashville, TN)
- …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more
- Highmark Health (Nashville, TN)
- …SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... utilization , identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- Highmark Health (Nashville, TN)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- HCA Healthcare (Chattanooga, 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 ... in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with...growth, we encourage you to apply for our Mental Health Therapist - Outpatient opening. We promptly review… 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 ... years. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- Veterans Affairs, Veterans Health Administration (Knoxville, TN)
- …clinical case management, discharge planning, medical services, managed care utilization review , resource allocation, organizational structure and function, ... and intervention, evidenced through the ability to present histories, assessments, behavioral observations, mental health assessment results, and discuss… more
- Highmark Health (Nashville, TN)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Highmark Health (Nashville, TN)
- …have budgetary responsibility and authority. + Understand budget and resource utilization across the product teams. Escalate any issues regarding product delivery ... budgets and review action plans with product owners. + Provide oversight...care management functions + Understanding of Care Management & Utilization Management business processes **LICENSES or CERTIFICATIONS** **Required** +… 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 ... treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile… more
- Prime Therapeutics (Nashville, TN)
- …contract(s) and manages the overall client relationship. The position supports drug utilization review (DUR) efforts by reviewing physician prescribing patterns, ... network, pharmacy or project management. + Knowledge of current research related to behavioral health medications. + Behavioral health /substance abuse… more
- Vanderbilt University Medical Center (Nashville, TN)
- …state and local associations. + National representation at Association of Ambulatory Behavioral Health (AABH). + Administrative backup coverage for Assistant ... support of program/project objectives. + Develop financial information for review and analysis. + Present financial data and recommendations...Director of Behavioral Health Ambulatory Clinics . + Collaborates… more
- HCA Healthcare (Brentwood, 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 ... area. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- Sevita (TN)
- …accurate record-keeping for all clinical services, documents, assessments, progress, and activity; review records and logs to stay abreast of changes in service ... process for clinical employees; in consultation with human resource personnel, review written warnings and approve all involuntary terminations for state-level… more
- HCA Healthcare (Brentwood, 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 ... years. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Brentwood, 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 ... years. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more