- Mindlance (Syracuse, NY)
- …community resource needs for coordinating, integrating, and monitoring the use of medical and health care services for members; The SN UAS Nurse may also perform ... A minimum of four years clinical experience in ambulatory care , community health or home health...or other regulatory bodies, to determine functional status, medical, behavioral , psychological, and community resource needs, as well as… more
- Kepro (Richmond, VA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (PRN, Remote within Virginia) with an ... LBA to join our growing team. Job Summary: Our Behavioral Health UM Clinical Reviewer...against criteria to determine medical necessity and appropriateness of care ; determine if the medical record documentation supports the… more
- Molina Healthcare (Bronx, NY)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... our Senior Whole Health business.** **_Senior Whole Health by Molina_** **is a Managed Long-Term Care...programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies… more
- Universal Health Services (Oakland Park, FL)
- Responsibilities Fort Lauderdale Behavioral Health Center, a subsidiary of UHS , is a beautiful, conveniently located, private 180-bed hospital that specializes ... through the analysis, review and evaluation of clinical practices within the Behavioral Health Center. Other duties include; recommending plans of corrective… more
- Elevance Health (Tampa, FL)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes. +...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- LifePoint Health (Las Cruces, NM)
- …of the discharge plan. * Discharge Planning assists with LTC, SNF, Rehabilitation, Behavioral /Mental Health , Home Care , DME, transportation and other ... Memorial Medical Center is a 199-bed hospital offering a spectrum of care , including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and… more
- Universal Health Services (Orlando, FL)
- …94,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ... FL. The hospital provides 24-hour emergency services. Central Florida Behavioral Hospital offers a full continuum of care...Time Off + Free Basic Life Insurance About Universal Health Services One of the nation's largest and most… more
- Healthfirst (NY)
- …managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management, Utilization Management, Behavioral Health , etc.) and may ... providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care /case… more
- One Health (Sheridan, WY)
- …to perform the essential job functions. + Supports and coordinates behavioral health services with the patient's integrated care team. + Assists the ... Engages with patients during warm hand-offs to offer support, education about integrated care , resources, and behavioral health intake processes. Assists… more
- One Health (Hardin, MT)
- …to perform the essential job functions. + Supports and coordinates behavioral health services with the patient's integrated care team. + Assists the ... during warm hand-offs to offer support, education about integrated care , resources, and behavioral health ...and grant supported programs implemented by One Healt MINIM UM JOB QUALIFICATIONS: E du c ation/Certificates/Licenses: Required ▪… more
- One Health (Hardin, MT)
- …of our patients! P OSITION SUMMARY: Functions as a core member of an integrated behavioral health team that may involve the patient's primary care provider ... federal confidentiality requirements. Works under the direction of licensed behavioral health and/or medical providers, is responsible...services to rural populations through an integrated approach to health care . One Health provides… 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 ... depression, and insightful analytics to improve the delivery of care . ** Behavioral Health Care...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Elevance Health (Woburn, MA)
- …** Behavioral Heath Care Manager II** + Job Family: MED > Licensed/Certified Behavioral Health Role + Type: Full time + Date Posted:Apr 23, 2024 + ... for ABA service for the plans contracted by Carelon Health . The care manager reviews the provider's...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Humana (Richmond, VA)
- …management of behavioral and physical health services, including Care Management (CM), Utilization Management ( UM ), Quality Improvement, and value‐based ... antipsychotics for all Members; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health ‐related concerns… more
- Point32Health (MA)
- …and regulatory guidelines described in legacy Tufts Health Plan or Harvard Pilgrim Health Care UM Policy and Procedure Manual. + Render medical necessity ... a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health,… more
- Molina Healthcare (Albuquerque, NM)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies... Health field **Required Experience** 3+ years Behavioral Health hospital acute care /medical… more
- UNC Health Care (Chapel Hill, NC)
- …Exempt From Overtime: Exempt: Yes This is a State position employed by UNC Health Care System. Qualified applicants will be considered without regard to their ... 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve....and YBH. The team assists the weekends and other UM teams with their reviews. Schedule: Fulltime: Day Shift… more
- LA Care Health Plan (Los Angeles, CA)
- …This position also acts as a liaison between the Plan Partners and PPGs and LA Care Health Plan regarding UM issues. The position assists in improving access ... $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public... Health units, the Medical Director of Behavioral Health , attendance at UM … more
- Centene Corporation (Tallahassee, FL)
- …WORK SCHEDULE IS MONDAY-FRIDAY, 8AM - 5PM. THESE ROLES WILL BE SUPPORTING BEHAVIORAL HEALTH UTILIZATION MANAGEMENT FOR MEDICAID. **Position Purpose:** Performs a ... clinical review and assesses care related to mental health and substance...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Molina Healthcare (Albuquerque, NM)
- …mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. ** Based in New ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and...regional medical necessity reviews and cross coverage * Standardizes UM practices and quality and financial goals across all… more
