- Battelle Memorial Institute (Arlington, VA)
- …**Responsibilities** + Assist with the management and treatment of outpatient behavioral health activities + Under the supervision of a licensed ... working in a dynamic, mission-driven environment. This position supports outpatient behavioral health activities by conducting intake interviews, assisting with… more
- Battelle Memorial Institute (Arlington, VA)
- …environment. The Licensed Clinical Social Worker position serves as a behavioral health care provider within operational units, delivering evidence-based ... **Responsibilities** + Function within an operational unit as a Behavioral Health Care Provider + Attend and...health consultant and/or psychiatry consultant + Perform case management functions **Key Qualifications** + Master of Social Work… more
- Humana (Annapolis, MD)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Immigration and Customs Enforcement (Washington, DC)
- …Perform other duties and responsibilities as assigned. 16. Utilization review/ management for inpatient behavioral health hospitalization for IHSC. ... Summary The Behavioral Health Case Manager is a...case coordination/ management , monitoring high risk individuals, independent behavioral health reviews, behavioral … more
- Elevance Health (Hanover, MD)
- …abuse cases preferred. **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly ... Behavioral Health Care Manager I- ... Behavioral Health Care Manager I- Behavioral ...there is licensed staff supervision. Previous experience in case management / utilization management with a broad… more
- AmeriHealth Caritas (Washington, DC)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity...for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring… more
- Humana (Washington, DC)
- …clinical services . Experience in utilization management review and case management in a health plan setting . No current sanction from Federal or ... part of our caring community and help us put health first** The Behavioral Health ...a focus on collaborative business relationships, value-based care, population health , or disease or care management +… more
- Johns Hopkins University (Baltimore, MD)
- …enrollment and appointments for specialty substance use services and behavioral health care. + Manage tracking and utilization of resources. + Register ... Medicine is seeking a full time **_Substance Use & Behavioral Health Linkage_** . Under the direct...organized and detail oriented. + Excellent organizational and time management skills. + Independent and self-motivated. + Ability to… more
- Highmark Health (Washington, DC)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving ... function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Washington, DC)
- …:** **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
- BrightSpring Health Services (Baltimore, MD)
- …pharmacy, home health care and primary care, and rehabilitation and behavioral health , we provide comprehensive and more integrated care and clinical ... utilization and hospital admission reduction. + Provides survey management support/ follow-up/and coordination of corrective actions plans relatied to care… more
- Highmark Health (Washington, DC)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... decisions, ensuring alignment with the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care received, and optimal… more
- Highmark Health (Washington, DC)
- …residency program + 5 - 7 years in Pharmacy + 3 - 5 years in Pharmacist - Utilization Management + 3 - 5 years in Pharmacist - Medical Therapy Management ... are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent then conducts thorough research to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Washington, DC)
- …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
- AmeriHealth Caritas (Washington, DC)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... for improvement + Compiles documentation regarding quality Reports and provider utilization platforms. + Will partner with medical management team… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- … Health Program (ICMHR) Registered Nurse (RN) is a member of the Behavioral Health Care Service Line whose role is to collaboratively manage, coordinate ... the purpose of improving care to patient groups, maximizing utilization of resources and enhancing the case management...as related degrees. Preferred Qualifications Minimum 1 year Case Management Minimum 2 years Mental Health experience… more
- Highmark Health (Washington, DC)
- …to set health goals by working cooperatively with medical providers, case management departments and/or health plans to help ensure that patients have ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This...resources appropriate to the needs of patients/families and ongoing utilization of resource database. (5%) + Other duties as… more
- Johns Hopkins University (Baltimore, MD)
- …leadership team call schedule, which provides consultative support to the JHU Behavioral Health Crisis Support Team. **Specific Duties and Responsibilities** + ... and seminars. + Remains abreast of current literature and research on student behavioral health and evidence-based interventions. + Actively contributes to MHS… more
- Highmark Health (Washington, DC)
- …impact corporate performance + Researches, manipulates, and prepares data related to Health Management programs that document program activities and the results ... the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role...of Health Management… more
- CVS Health (Washington, DC)
- …. 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
