- Humana (Richmond, VA)
- **Become 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 2 work… more
- Elevance Health (Richmond, VA)
- …of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff ... ** Behavioral Health Care Manager II - Autism** **Location:**...supervision. + Previous experience in case management / utilization management with a broad… more
- Elevance Health (Richmond, VA)
- …Skills, Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) ... ** Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required… more
- Elevance Health (Richmond, VA)
- …of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff ... supervision.) **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of… more
- CVS Health (Richmond, VA)
- …Aetna. **Expectations and Responsibilities:** * Serve as the principal utilization management reviewer for cases related to Applied Behavior Analysis (ABA). ... medical directors. * Attend and actively participate in clinical meetings with care management and utilization management teams, offering subject matter… more
- Highmark Health (Richmond, VA)
- …supporting, and optimizing the architectural strategy for **all clinical and utilization management applications** . Their expertise spans application, solution, ... and AI integration, extending this strategic oversight across **all clinical and utilization management applications** . This involves ensuring the completeness… more
- Highmark Health (Richmond, VA)
- …and mentorship in areas of expertise and architecture to peers, developers, management , and business users. **Key Responsibilities:** + Lead the design and ... application designs to ensure optimal technology selection, efficient resource utilization , and seamless system integration. + Ensure system architecture adheres… more