- Humana (Springfield, IL)
- …us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- Trinity Health (Berwyn, IL)
- …the department. **OUTPATIENT:** Conducts group therapy sessions and performs case management responsibilities for behavioral health patients participating ... opportunity for a LCPC/LCSW in the Outpatient Counseling Clinic - Berwyn, Illinois. The Behavioral Health team is seeking future colleagues with a passion to… more
- Humana (Springfield, IL)
- …administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and ... specialists + Develops comprehensive care programs for the management of adult behavioral health ...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Behavioral Health Strategy Lead Behavioral Health Executive Leader (known ... to Humana as a Behavioral Health Strategy Lead role) is responsible for defining, implementing, and advancing the strategic vision of behavioral health … more
- Health Care Service Corporation (Chicago, IL)
- …+ Board certified in psychiatry in good standing. + 5 years clinical experience in behavioral health care management . + Located in a state or territory ... A Board Certified Psychiatrist Responsible For Medical Necessity Determinations With Respect To Behavioral Health Disorders At All Levels Of Care Which Includes… more
- Centene Corporation (Great Lakes, IL)
- …perspective on workplace flexibility. **On-Site Opportunity** **Centene is hiring a On-Site Behavioral Health Care Manager in Waukegan, Illinois.** **Are you a ... Illinois Health Plan is hiring a On-Site Behavioral Health Care Manager to work on-site...in the State of Illinois** + **Experience in case management and/or utilization management ** +… more
- Highmark Health (Springfield, IL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- Elevance Health (Chicago, IL)
- …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... medical director provides clinical expertise in all aspects of utilization review and case management . Provides input...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Highmark Health (Springfield, IL)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Highmark Health (Springfield, IL)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... processing of pre-certification requests for authorization of medically necessary health care services, at the appropriate level of care,...and management . + Route Cases Based on Established Guidelines. +… more
- CVS Health (Springfield, IL)
- …. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience.… more
- Humana (Springfield, IL)
- … who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management . The Manager, Care Management , ... of staff including service performance and adherence to established utilization and care coordination benchmarks. **Use your skills to...or more years of professional experience working in the health care industry and/or in care management .… more
- US Marine Corps (Marine, IL)
- …to anxiety, depression, stress, coping and other factors which detract from an individual?s behavioral health . Serves as Subject Matter Expert (SME) on all ... Program services. Implements policies, conducts risk assessments, and case management services for the Marine Intercept Program (MIP) and...Behavioral Health services, to include conducting risk… more
- Carle Health (Urbana, IL)
- …Health Information Systems (HIM), Patient Financial Services (PFS), Compliance, Case Management / Utilization Management , Revenue Cycle Systems & Training ... Overview The Director of Patient Access Services is responsible for the management of the system's Patient Access Services processes, policies and procedures to… more
- Highmark Health (Springfield, IL)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job plays a key role in ensuring projects (ie change initiatives) meet objectives on time ... and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …in Basic Life Support (BLS); Be acquainted with acute medical/surgical, psychiatric, behavioral health , and long term care clinical treatment environments. Grade ... Summary The Captain James A. Lovell Federal Health Care Center (FHCC) is seeking a Registered...unit. Uses established bed control monitor devices, ie, Bed Management System (BMS), Emergency Department Integrated System (EDIS), Capacity… more
- Highmark Health (Springfield, IL)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
- ChenMed (Oak Lawn, IL)
- …physical exam, diagnosis and treatment, development of the plan of care, health education, specialty referrals, case management referrals, follow-up and clear ... informed decisions re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and reimbursement for… more
- Highmark Health (Springfield, IL)
- …within the Scrum Master and PO CoE teams through coaching, performance management , and fostering collaboration. The manager provides **oversight for Scrum Masters** ... **leading the Agile Transformation** , including strategic planning, change management , stakeholder engagement, tracking transformation metrics, and fostering continuous… more