- Humana (Annapolis, MD)
- …and help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Utilization Management ( Behavioral Health) who will utilize ... of behavioral health services and/or benefit administration determinations. The Manager , Utilization Management ( Behavioral Health) applies… more
- Elevance Health (Washington, DC)
- …degrees of medical complexity and acuity. Participates in case and/or utilization management execution/decision making for managed member populations. Primary ... II HCMS is responsible for managing a team of physical and/or behavioral health practitioners in the development, implementation, and coordination of a comprehensive… more
- Elevance Health (Washington, DC)
- …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 appropriate and...Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical… more
- The Arora Group (Bethesda, MD)
- …Managers: Care Manager Certified (CMC) + Experience: + Referral Management / Utilization Management (RM/UM) experience. + Clinical subspecialty experience ... certifications: + Commission for Case Manager Certification Certified Case Manager (CCM) + Certification of Disability Management Specialists Commission:… more
- CenterWell (Washington, DC)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... ER visits, readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management programs with primary… more
- Elevance Health (Hanover, MD)
- …provider assignments and oversight of daily activities and provide feedback to manager on performance management , day-to-day training, guidance, and workflow of ... A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and… more
- Elevance Health (Fairfax, VA)
- …and insightful analytics to improve the delivery of care. The **ARTS Case Manager ** is responsible for overall management of member's individual service plan ... **Addiction (ARTS) Case Manager ** **MUST LIVE WITHIN THE TIDEWATER REGION** **(Accomack...member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical… more
- Centene Corporation (Arlington, VA)
- …Associate's Degree in nursing** **Candidate Experience:** Required 2+ years of experience in utilization management and/or case management in a hospital or ... and facilities/agencies. + Coordinates community resources, with emphasis on medical, behavioral , and social services. Applies case management standards,… more
- Ford Motor Company (Washington, DC)
- …is best-in-class. **In this position ** The Accessories eCommerce Merchandising Manager is responsible for deeply understanding customer needs and optimizing the ... business value daily by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion, and customer… more
- Ford Motor Company (Washington, DC)
- …is best-in-class. **In this position ** The Non-Vehicle eCommerce Operations Senior Manager is responsible for deeply understanding B2C and B2B Parts and Accessories ... efficiency and customer satisfaction by pulling, analyzing, and translating analytics and behavioral data into actionable insights with forecasted values for each to… more
- CenterWell (Washington, DC)
- …health and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management , care management , clinical information ... the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative care, post-acute care, transitions of care) at a population… more
- CenterWell (Washington, DC)
- …optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and serve as a national clinical program leader ... This role reports to the National Director, High Risk Patient Management . Responsibilities will include: + Lead comprehensive clinical pharmacy service development,… more
- Highmark Health (Washington, DC)
- …performance and compliance monitoring. This position will continuously engage Procurement Management to review performance and key performance indicators and take a ... functional business clients to drive best practice adoption, optimized system utilization and continuous process improvement outcomes. + Develop and maintain… more
- HCA Healthcare (Dulles, VA)
- …capital equipment requests + You will be responsible for the fiscal management of department; assures proper utilization of organization's financial resources ... 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 medical… more