- Humana (Cincinnati, OH)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Molina Healthcare (Covington, KY)
- …equivalent experience * 2 or more years in case, disease, or utilization management ; managed care; or medical/ behavioral health settings. * Proficient in ... development, implementation, and collaboration with the delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. **Job… more
- Bon Secours Mercy Health (Batavia, OH)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more
- Molina Healthcare (Cincinnati, OH)
- …RN license The Care Review Clinician will provide prior authorization for OH Medicaid behavioral health population. Experience in Behavioral Health ... use disorders and familiarity with ASAM criteria. Familiarity with utilization management and experience using MCG, PEGA....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members… more
- Molina Healthcare (Covington, KY)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be given to those whose… more