- 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
- 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 (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
- Elevance Health (Nashville, TN)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer… 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 (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** HealthTrust, 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 ... 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
- 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
- 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 ... the therapy services offered by Reliant Rehabilitation. + Participate in utilization review , quality assurance, resident care conferences, admission meetings,… 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 ... Chain, 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
- Sharecare (Nashville, TN)
- **Job Description:** Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all ... their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans,… more