- Humana (Boise, ID)
- …and help us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral ... years of clinical and Utilization Management experience. The Utilization Management Behavioral Health Nurse completes medical record reviews from… more
- Humana (Boise, ID)
- …community and help us put health first** Humana Healthy Horizons 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
- Humana (Boise, ID)
- …+ Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health . + Detailed working knowledge in ... degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management...Working knowledge using Power BI + Registered Nurse or Behavioral Health Licensed Professional. + Managed care,… more
- Kaniksu Community Health (Sandpoint, ID)
- …their health needs. From prevention and wellness to medical, dental, and behavioral health . From pediatric to geriatrics, we believe that quality healthcare ... + Tuition reimbursement. + 4% 401K employer match. + In-house medical, dental, or behavioral health services. + Year round, affordable on-site childcare at KCH… more
- Humana (Boise, ID)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such as ... part of our caring community and help us put health first** The Behavioral Health ...health insurance, other healthcare providers, clinical group practice management . + Utilization management experience… more
- Highmark Health (Boise, ID)
- …account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case/ disease management ... information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a...review. + Assist in the development and implementation of utilization management programs including but not limited… more
- Magellan Health Services (Boise, ID)
- Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including ... as appropriate. + Provides care coordination to members with behavioral health conditions identified and assessed as...or relevant experience in lieu of degree., Experience in utilization management , quality assurance, home or facility… more
- Magellan Health Services (Pocatello, ID)
- …in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. ... Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge and experience in inpatient… more
- Magellan Health Services (ID)
- …in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. ... Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge and experience in inpatient… more
- Highmark Health (Boise, ID)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of...0 - 1 year of experience working in the Health Insurance Industry **LICENSES AND CERTIFICATIONS** **Required** + None… more
- Humana (Boise, ID)
- …experience leading teams focusing on quality management , utilization management , discharge planning and/or home health or rehab. + Strategic thinking ... the senior population with a strong lens on intersecting behavioral and social health needs. + Provide...management , utilization management , case management , discharge planning and/or home health or… more
- Behavioral Health Solutions (Boise, ID)
- Behavioral Health Solutions is a leading provider of comprehensive behavioral health services for adult and geriatric patients across various healthcare ... + Prescribe medications and formulate treatment plans for patients with mental health disorders. + Administer ongoing medication management , closely monitoring… more
- Highmark Health (Boise, ID)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job implements and maintains state-of-the-art procurement, payables , sourcing, or ... performance and compliance monitoring. This position will continuously engage Procurement Management to review performance and key performance indicators and take a… more
- Elevance Health (Meridian, ID)
- …evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and community services ... the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current needs… more
- Highmark Health (Boise, ID)
- …contribute to highest levels of performance. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but limited to: involved in hiring and ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct, and control… more
- Highmark Health (Boise, ID)
- …with the Software Lifecycle + 3 years of Advanced domain experience **Preferred** + Utilization Management product experience highly preferred + 3 years with the ... + Business Acumen for P&Ls + Communication + Conflict Management **Language (Other than English):** None **Travel Requirement:** 0%...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Humana (Boise, ID)
- …+ Administer new innovative VBP models for range of provider types, such as behavioral health , maternity, specialists, and social determinants of health , ... **Become a part of our caring community and help us put health first** The Sr. Value-Based Programs professional supports successful value-based provider… more
- HCA Healthcare (Idaho Falls, ID)
- …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 ... East Falls Primary Care, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs… more
- Marriott (Boise, ID)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... + Experience in waterfall and/or agile software methodologies + Vendor management experience **Preferred Qualifications:** + Graduate degree + Oracle Global Human… more
- Humana (Boise, ID)
- …opportunities which may support Member Engagement, Clinical Performance, Provider Engagement, Behavioral Health and Pharmacy. + Exercises considerable latitude ... of key utilization and financial performance measures related to Population Health ) + Proficiency in verbal and written communication to senior and executive… more