- Evergreen Health (Jamestown, NY)
- …patients to needed services to support care plan including medical and behavioral health care, patient education, entitlement programs, self-help groups, and ... Evergreen Health The Telephonic Care Coordinator applies...Care Coordinator is responsible for the following outcomes: Reduce utilization associated with avoidable and preventable inpatient stays; reduce… more
- Humana (Helena, MT)
- …of contact for the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate with other Medical Management ... part of our caring community and help us put health first** The ** Telephonic Nurse Case Manager**...(SDOH). Plan shall include psychosocial issues, home environment and behavioral health needs across the full continuum… more
- Humana (Indianapolis, IN)
- …us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral ... frame. Individual shift to be discussed during the interview. The Utilization Management Behavioral Health Nurse completes medical record reviews from… more
- CVS Health (Harrisburg, PA)
- …experience (team is not accepting applicants whose only acute care experience is in behavioral health ) - 3+ years' experience with Microsoft Office Suite with ... Bring your heart to CVS Health . Every one of us at CVS ...care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- Elevance Health (Oakland, CA)
- …a check, or ask you for payment as part of consideration for employment. ** Behavioral Health Manager II** + Job Family: MED > Licensed/Certified Behavioral ... California, San Mateo + California, Alameda + California, Berkeley **Description** **JR78744 Behavioral Health Manager II** We are presently seeking a dedicated… more
- CVS Health (Harrisburg, PA)
- …completing medication reconciliation, provider referrals for aftercare and locating community based behavioral health resources as well as locating resources for ... - 3+ years of direct clinical practice experience - Master's degree in behavioral health field with unrestricted license in state of residence (ex:… more
- CVS Health (Salt Lake City, UT)
- …member outreaches and computer documentation.* Assist members with locating community based behavioral health resources. Required Qualifications - 3+ years of ... direct clinical practice experience- An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC,… more
- CVS Health (Salt Lake City, UT)
- …member outreaches and computer documentation.* Assist members with locating community based behavioral health resources. Required Qualifications - 3+ years of ... direct clinical practice experience- An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC, LCSW, LMFT, LPCC,… more
- Universal Health Services (Groton, CT)
- …ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access ... Department Head and Billing of any denials and complete telephonic or written appeals when necessary. + Liaison between...or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health … more
- Highmark Health (Dover, DE)
- …**JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The...and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member… more
- CareOregon (Medford, OR)
- …system of care principles and practices + Knowledge of Behavioral Health managed care practice, including utilization management, population health ... Job Title CCO Behavioral Health Program Manager - Adult...in the compliance monitoring of provider network to review utilization , quality improvement, and evaluation programs for members within… more
- Elevance Health (Las Vegas, NV)
- …you a check, or ask you for payment as part of consideration for employment. ** Behavioral Health Care Manager II** + Job Family: MED > Licensed/Certified ... Behavioral Health Role + Type: Full time...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.… more
- CVS Health (Richmond, VA)
- …treatment resources, mental health managed care programs, and Aetna Behavioral Health policies and procedures, and criteria.- Interact with Supervisors ... or alternative care setting such as ambulatory care or outpatient clinic/facility.- Qualifying Behavioral Health degree (ie LPC, LPCC, LISW, LCSW).- 2+ years of… more
- WellSense (Manchester, NH)
- …health (BH) and substance use services. The Licensed Behavioral Health Clinician works alongside medical Utilization Management and medical Care ... Licensed Behavioral Health Clinician WellSense Health...Functions/Responsibilities:** + Performs a variety of diverse and complex telephonic and face-to-face care management responsibilities and ensures that… more
- Spokane County (Spokane, WA)
- …providing behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health services for eligible ... Health Administrative Services Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review Integrated… more
- Elevance Health (Atlanta, GA)
- …care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational ... care for multiple managed conditions to ensure cost-effective and efficient utilization of health services. Conducts assessment, planning, implementation,… more
- Highmark Health (Wilmington, DE)
- …:** **JOB SUMMARY** This job leads a physician team and ensures that utilization management responsibilities are performed in accordance with the highest and most ... of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The...ensuring that those measures are met. In addition to utilization review, the physician teams participate as physician members… more
- Fairview Health Services (Wyoming, MN)
- …future. M Health Fairview Clinics was named one of eight "exemplar" integrated behavioral health primary care models across the country. Integrated care is a ... result of an engaged primary care team and Behavioral Health Clinician providing patient-centered care addressing...determinants of health , and ineffective patterns of health care utilization . At M Health… more
- Elevance Health (Cary, NC)
- …of consideration for employment. **BH Care Manager I** + Job Family: MED > Licensed/Certified Behavioral Health Role + Type: Full time + Date Posted:Feb 19, 2024 ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.… more
- CVS Health (Springfield, IL)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...and outbound touchpoints to solve members' needs and create behavioral change. How we do this is through a… more