- Humana (Nashville, TN)
- …and assists corporate leadership in strategic planning to improve effectiveness of behavioral health utilization management programs. + Collects and ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health ) who will utilize their clinical… more
- CVS Health (Nashville, TN)
- …using Motivational Interviewing and good technological skills + Valid unrestricted independent professional behavioral health clinical license to practice ... - Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Elevance Health (Nashville, TN)
- …responsible for appeals reviews within our Medicaid and Medicare programs.** The ** Behavioral Health Medical Director** is responsible for the administration of ... behavioral health medical services, to ensure the...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- CenterWell (Nashville, TN)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... **Become a part of our caring community and help us put health first** The Patient Assessment and Navigation Professional oversees the enrollment, education,… more
- Universal Health Services (Memphis, TN)
- Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate ... 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in...patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement… more
- Elevance Health (Nashville, TN)
- …PST.** The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... or territory of the United States when conducting a utilization review or an appeals consideration and cannot be...For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5… more
- Covenant Health Inc. (Knoxville, TN)
- …Position Summary: Responsibility for the daily operations of Peninsula's Behavioral Health Home including; oversight of utilization of the "Care Coordination ... issuing authority. Minimum Experience: A minimum of two years' experience in behavioral health preferred. Management experience and previous experience in… more
- BrightSpring Health Services (Nashville, TN)
- …offered by the company or campus + Utilizes competencies in sourcing, behavioral interviewing, selection, and effective utilization of the company's Applicant ... Our Company BrightSpring Health Services Overview The Talent Acquisition team works...networking and college relationships. Solicits and pursues referrals from professional associations and internal referrals from our employees +… more
- Elevance Health (Nashville, TN)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... state or territory of the United States when conducting utilization review or an appeals consideration and cannot be...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- CenterWell (Nashville, TN)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** **National** **Director of Transitional Care and High-Risk...will play a pivotal role in reducing acute care utilization for top 5% of complex patients and ensuring… more
- Highmark Health (Nashville, TN)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- Mindoula Health (Collierville, TN)
- …you successful: + Bachelors degree in psychology, social work, or another applicable behavioral health discipline from an accredited college or university is ... basis + Develop and coordinate community resources with emphasis on medical, behavioral , violence prevention, and social services. + Assess members for risk, make… more
- HCA Healthcare (Hendersonville, 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...quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care… more
- Universal Health Services (Brentwood, TN)
- …ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access ... is a nationwide leader in the treatment of co-occurring addiction and mental health disorders. With 11 residential and outpatient facilities across the US, FRN aims… more
- Highmark Health (Nashville, TN)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job supports the retention of existing accounts and the acquisition of new members/contracts ... and quotes. Runs financial reports or performs basic financial analysis on utilization data and market research and analysis. Develop detailed specifications for… more
- Highmark Health (Nashville, TN)
- …software engineers as needed on ETO Digital team. + Comprehension and utilization of the newest, emerging, innovative technologies and applications + Apply lead ... learn other programming languages as needed + Knowledge of professional software engineering practices & best practices for the...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CenterWell (Nashville, TN)
- … health and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management, care management, clinical information ... directly address the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative...well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up… 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 ... TriStar Skyline Medical Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- WestCare Foundation (Dandridge, TN)
- …in Sociology, Criminal Justice, Social Work, Psychology or related human services or behavioral health field for this position is preferred. + Previous ... or equivalent is required. Experience and Competencies: + Basic knowledge of behavioral health , therapeutic techniques, social services, or related industry. +… 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