- Molina Healthcare (Lincoln, NE)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- Highmark Health (Lincoln, NE)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Highmark Health (Lincoln, NE)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- CenterWell (Lincoln, NE)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- Humana (Lincoln, NE)
- …make an impact** **Reporting Relationship:** This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with ... community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and… more
- Evolent (Lincoln, NE)
- …as required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted ... also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our... reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,… more
- Molina Healthcare (Lincoln, NE)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... from authorization requests or for additional information as requested by the Medical Director . **Job Qualifications** **Required Education** HS Diploma or GED… more