- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current ... a committed, caring group of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating… more
- Lincoln Financial (Nashville, TN)
- …1 year in claims, disability management (STD/LTD), worker's compensation, utilization review , and or behavioral health case management . Certified ... are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization....disability claims. You will act as a resource to review , analyze, and interpret medical information as well as… more
- Humana (Nashville, TN)
- …+ Experience with utilization review process. + Experience with behavioral change, health promotion, coaching and wellness. + Knowledge of community ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral … more
- Evolent (Nashville, TN)
- …which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point...proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be… more
- Highmark Health (Nashville, TN)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member… more
- Highmark Health (Nashville, TN)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- HCA Healthcare (Chattanooga, TN)
- …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 ... in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with...growth, we encourage you to apply for our Mental Health Therapist - Outpatient opening. We promptly review… more
- Elevance Health (Nashville, TN)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer… more
- Highmark Health (Nashville, TN)
- …and timely processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care, based on the ... nurse reviewer and other departments based on documentation procedures, including review type, clinical information, and decision timeframes. Follow policies and… more
- Highmark Health (Nashville, TN)
- …lower-level staff. + Train, develop, and mentor staff. + Assign, monitor, and review progress and accuracy of work. + Provide technical leadership in first-line ... to maximize appropriate use of resources. + Optimize the utilization of resources by applying appropriate concepts, technologies and...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- HCA Healthcare (Nashville, TN)
- …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 ... Home, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...regarding payer requirements. + Performs data analysis related to utilization review (UR) metrics, works with hospital… more
- HCA Healthcare (Nashville, TN)
- …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 ... years. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Nashville, TN)
- …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 ... **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Brentwood, TN)
- …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 ... area. **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Nashville, TN)
- …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 ... HealthTrust, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...is to support capital equipment quote submissions with robust review to ensure member terms and conditions are met,… more
- HCA Healthcare (Nashville, TN)
- …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 ... HealthTrust Supply Chain, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Nashville, TN)
- …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 ... Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...within a deadline + Knowledge of case management and/or utilization review preferred + Ability to manage… more
- HCA Healthcare (Nashville, TN)
- …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 ... the therapy services offered by Reliant Rehabilitation. + Participate in utilization review , quality assurance, resident care conferences, admission meetings,… more
- HCA Healthcare (Dickson, TN)
- …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 ... TriStar Horizon Medical Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- HCA Healthcare (Nashville, TN)
- …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 ... **Benefits** HCA Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more