- Humana (Richmond, VA)
- …and assists corporate leadership in strategic planning to improve effectiveness of behavioral health utilization management programs. + Collects and ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health ) who will utilize their clinical… more
- CVS Health (Richmond, VA)
- …(MCO). + Experience with supervision of community-based Medicaid behavioral health services. + Experience in completing utilization management tasks + ... They represent the plan and collaborate with internal partners, community organizations, and behavioral health and ARTS providers to enhance the quality of… more
- Elevance Health (Richmond, VA)
- …responsible for appeals reviews within our Medicaid and Medicare programs.** The ** Behavioral Health Medical Director** is responsible for the administration of ... behavioral health medical services, to ensure the...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Kepro (Richmond, VA)
- … UM Clinical Reviewer (part-time) to join our growing team. Job Summary: Our Behavioral Health Utilization Management Clinical Reviewer will use clinical ... CNSI and Kepro are now Acentra Health ! Acentra Health exists to empower...in sufficient detail in correspondence. + Foster positive and professional relationships and liaise with internal and external customers… more
- HCA Healthcare (Richmond, VA)
- …**Introduction** Do you have the career opportunities as a(an) Supervisor House Admin Behavioral Health you want with your current employer? We have an ... services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed… more
- CVS Health (Richmond, VA)
- …(eg Utilization Management, Care Management) coordinate processes related to behavioral and physical health services, involving primary care physicians and ... service providers through provider education on behavioral and physical health , social service needs, and utilization Required Qualifications + Requires… more
- CenterWell (Richmond, VA)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... **Become a part of our caring community and help us put health first** The Patient Assessment and Navigation Professional oversees the enrollment, education,… more
- Elevance Health (Richmond, VA)
- …PST.** The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... or territory of the United States when conducting a utilization review or an appeals consideration and cannot be...For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5… more
- Universal Health Services (Petersburg, VA)
- …guided by its mission of helping those who need the full continuum of behavioral health services. Our facility offers behavioral and psychological treatment ... employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access… more
- Molina Healthcare (Glen Allen, VA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Services & Supports... Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or… more
- Elevance Health (Richmond, VA)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... state or territory of the United States when conducting utilization review or an appeals consideration and cannot be...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Highmark Health (Richmond, VA)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- CenterWell (Richmond, VA)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** **National** **Director of Transitional Care and High-Risk...will play a pivotal role in reducing acute care utilization for top 5% of complex patients and ensuring… more
- Bon Secours Mercy Health (Richmond, VA)
- …Inter- professional collaboration and leadership + * Understanding and utilization of office and clinical technologies + * Compassionate, relationship-based ... At Bon Secours Mercy Health , we are dedicated to continually improving ...collaboration with other members of the healthcare team incorporating professional practice model into the care delivery + Demonstrates… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- 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
- Bon Secours Mercy Health (Richmond, VA)
- 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
- CVS Health (Richmond, VA)
- 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 our brand - with heart at its center - our purpose… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... and skill based on principles of the biological, physical, behavioral , and social sciences + Application of the nursing...+ Coordination of patient care delivery + Evaluation of professional nursing practice to optimize goals and outcomes +… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... Responder is to provide confidential screening via telephone for psychiatric, behavioral and chemical dependency problems to Access center callers, including the… more