- Humana (Concord, NH)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such as ... part of our caring community and help us put health first** The Behavioral Health ...health insurance, other healthcare providers, clinical group practice management . + Utilization management experience… more
- Centene Corporation (Bedford, NH)
- …and case management activities **Education/Experience:** Master's in Social Work / Behavioral health . 5+ years of experience in managed care, utilization ... for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offering… more
- CenterWell (Concord, NH)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… more
- Highmark Health (Concord, NH)
- …member is responsible for building relationships, engaging clinicians, educating on Utilization Management policies and processes, developing workflows and ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...in provider setting. + 3 years of experience in utilization management /care management /QA/managed care … more
- Highmark Health (Concord, NH)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of...0 - 1 year of experience working in the Health Insurance Industry **LICENSES AND CERTIFICATIONS** **Required** + None… more
- Humana (Concord, NH)
- …experience leading teams focusing on quality management , utilization management , discharge planning and/or home health or rehab. + Strategic thinking ... the senior population with a strong lens on intersecting behavioral and social health needs. + Provide...management , utilization management , case management , discharge planning and/or home health or… more
- Beth Israel Lahey Health (Lawrence, MA)
- …a difference in people's lives.** Clinical Supervisor (LICSW / LMHC) - Community Behavioral Health Center located in Lawrence, MA. **Job Description:** + **Sign ... of the Urgent Care/Mobile Crisis Program, including the appropriate utilization and management of staff and quality...Medicaid and non-Medicaid services. Ensures smooth access to MassHealth behavioral health services in the area by… more
- Highmark Health (Concord, NH)
- …Bachelor's Degree in Clinical-related field, Business Administration, Healthcare Administration, Health Information Management , or related discipline, or ... Bachelor's Degree - Clinical-related field, Business Administration, Healthcare Administration, Health Information Management , or related field **EXPERIENCE**… more
- Elevance Health (Manchester, NH)
- …evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and community services ... 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
- CenterWell (Concord, NH)
- … 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
- Humana (Concord, NH)
- …+ Administer new innovative VBP models for range of provider types, such as behavioral health , maternity, specialists, and social determinants of health , ... **Become a part of our caring community and help us put health first** The Sr. Value-Based Programs professional supports successful value-based provider… more
- Sharecare, Inc. (Concord, NH)
- …of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. ... team. Facilitates communication exchange with primary managing physician and other providers, health plan, and the disease management program team. + Coordinates… more
- CenterWell (Concord, NH)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... leader will play a critical role in ensuring optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and… more
- HCA Healthcare (Derry, NH)
- …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 ... **Parkland Medical Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- Marriott (Concord, NH)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... + Experience in waterfall and/or agile software methodologies + Vendor management experience **Preferred Qualifications:** + Graduate degree + Oracle Global Human… more
- The Home for Little Wanderers (Windsor, NH)
- …distribution and triaging medical issues including direct administration of first aid, management of ongoing medical issues, and determining necessity of the ... utilization of urgent care or emergency room services. Camp...therapeutic summer camp serving youth with social, emotional, and behavioral challenges. Nurses work under the supervision of the… more
- HCA Healthcare (Derry, NH)
- …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...of equipment in the facilities and reporting of facility utilization /need. **In this role you will be responsible for:**… more
- Sevita (Lawrence, MA)
- MENTOR Adult Day Health , a member of the Sevita family, provides day programs for elders with complex medical or rehabilitative needs. This allows seniors to obtain ... accounting staff; identify any discrepancies to accounting staff + Coordinate utilization with the Case Manager relative to program participant's incentive account… more