- Humana (Madison, IN)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Molina Healthcare (Louisville, KY)
- …equivalent experience * 2 or more years in case, disease, or utilization management ; managed care; or medical/ behavioral health settings. * Proficient in ... development, implementation, and collaboration with the delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. **Job… more
- Molina Healthcare (Louisville, KY)
- …with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and... Health function provides leadership and guidance for utilization management and case management … more
- Elevance Health (Louisville, KY)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For… more
- Elevance Health (Louisville, KY)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... and overseeing clinical/non-clinical activities. Will also be responsible for utilization review/ management . May be responsible for developing and… more
- Elevance Health (Scottsburg, IN)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... care team, to ensure cost effective and efficient utilization of health benefits. + Decision making...management case load, highly preferred. + MA/MS in Health /Nursing preferred. + Travels to worksite and other locations… more
- CenterWell (Louisville, KY)
- …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** The Market CMO serves as a ...expertise. + Develop, implement and monitor the outcomes of utilization review and disease management programs to… more
- Molina Healthcare (Louisville, KY)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… more
- Molina Healthcare (Louisville, KY)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be given to those whose… more
- ChenMed (Louisville, KY)
- …DUTIES/RESPONSIBILITIES:** + Directs accountability for clinical outcomes and day-to-day management of Medical Directors in multiple centers within assigned market, ... with regular presence in the centers under direct management , and under the supervision of the Regional President. + Ensures successful clinical operations and… more
- HCA Healthcare (Louisville, KY)
- …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 ... Department services within the campus. 8. Monitor, document, and report student utilization of department services 9. Serve as the campus-level coordinator for… more