- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… more
- CVS Health (Providence, RI)
- …network management and clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with ... This person will oversee and be responsible for all behavioral health activities in the health..., physical health , and social determinants of health . The medical director will… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… more
- Evolent Health (Providence, RI)
- …from scrubs to jeans. **Collaboration Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of ... Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management team.… more
- Northeast Family Services (Warwick, RI)
- Northeast Family Services is seeking an experienced and dedicated Director of Behavioral Health Billing who will be responsible for overseeing all aspects of ... billing operations. This role will report to the Director of Operations and is responsible for overseeing a...billing experience + Must have billing experience in the behavioral health field + Advanced computer skills… more
- Highmark Health (Providence, RI)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... provide clinical leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP to insure standards… more
- CVS Health (Providence, RI)
- … health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our Models ... Bring your heart to CVS Health . Every one of us at CVS ...care management staff as they support of members' physical, behavioral and socioeconomic needs. * Partner closely with the… more
- Highmark Health (Providence, RI)
- …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
- CenterWell (Providence, RI)
- …Education, and work as a thought partner with Coding and Documentation Improvement Medical Director . The main responsibilities of the role are: + Determine ... strategy with clinical education team and CDI (coding and documentation improvement) medical director embedded in Clinical excellence. + Align clinician coding… more
- Highmark Health (Providence, RI)
- …conceptualize and design how people interact with finding and accessing virtual/physical medical and behavioral care in tight collaboration with our Experience, ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Marriott (Providence, RI)
- …to receive minimum of 7 holidays annually. All locations offer coverage for medical , dental, vision, health care flexible spending account, dependent care ... **JOB SUMMARY** Marriott has an exciting opportunity for a Director on the Corporate Systems team within the Finance...a course of action. + Professional Demeanor - Exhibits behavioral styles that convey confidence and command respect from… more
- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on ... of manual processes using AI and RPA (Robotics Process Automation) ** Behavioral Competencies:** * Exceptional leadership skills, marked by poise, positive influence,… more
- Charter Care Health Partners (Providence, RI)
- Summary: Under the direction of the System Director of Outpatient and Integrated Behavioral Health , ED Behavioral Health Social Workers will function ... as clinical Behavioral Health Social Workers in the Emergency Department and will... medical necessity criteria and ASAM criteria. The Behavioral Health Social Worker will have the… more
- Magellan Health Services (Newport, RI)
- …child daycare centers and schools, and consultation to installation command regarding behavioral health issues affecting military personnel and their family ... - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health , Master's - Social Work Education - Preferred License and… more
- Evolent Health (Providence, RI)
- …as required. + Entering data into a proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be submitted ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory… more
- Charter Care Health Partners (Providence, RI)
- Summary: Under the direction of the System Director of Outpatient and Integrated Behavioral Health , ED Clinicians will function as clinical Behavioral ... of care. Clinician will have working knowledge of insurance prior authorization, medical necessity criteria and ASAM criteria. Clinicians will have the ability to… more
- CVS Health (Woonsocket, RI)
- Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...touch and work with many teams, including Analytics & Behavioral Change, Retail Analytics, Business Intelligence in Marketing, Promo,… more
- Sharecare, Inc. (Providence, RI)
- …one or more of the following areas: NICU, Oncology, Transplant, Maternity, and/or Behavioral Health . + Training in motivational interviewing preferred. + Strong ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...providers or members to the Clinical Advocate Manager or Director when he/she identifies an opportunity for education or… more
- Conviva (Providence, RI)
- …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** This role is embedded within the clinical...CenterWell Primary Care Organization. This role reports to Associate Director of coding education and has a dotted line… more
- Brown University (Providence, RI)
- …Under the supervision of the leadership team (ie Principal Investigator, Project Director , and Project Manager), the RA provides recruitment, enrollment, and data ... with the ongoing implementation of randomized control trials to test behavioral interventions targeting HIV prevention and treatment; sexual and gender minority… more