- Elevance Health (Seven Fields, PA)
- …use disorder (SUD) services. Additional responsibilities may include participating in on-site quality external audits such as NCQA, Department of Human Services, and ... in alignment with Company policies and procedures + Provides recommendations for quality improvement studies including selection of valid and reliable indicators and… more
- RWJBarnabas Health (West Orange, NJ)
- …of Job Function The primary role is to support and maintain BH 's internal users and infrastructure. Provide application, Telecom, network, operating system and ... hardware configurations, process, database maintenance and applications. Provide customer-focused, quality service. Participating in Architecture Assessments. Job Qualifications Bachelors… more
- Banner Health (AZ)
- …and co-manages other insured and uninsured litigation across the Banner Health ( BH ) system upon request. Designs and directs the claims investigation process; ... requirements, as well as applicable professional standards. Provides all customers of BH with an excellent service experience by consistently demonstrating our core… more
- Centene Corporation (Tallahassee, FL)
- …level of care and services are medically appropriate related to behavioral health ( BH ) and/or autism spectrum disorder needs and clinical standards + Performs ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...accordance with ABA regulatory guidelines and criteria + Analyzes BH member data to improve quality and… more
- Elevance Health (Norfolk, VA)
- …you will make an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary ... quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as appropriate.… more
- Amergis (Orange, CA)
- …. Current CA unrestricted license such as LCSW, LPCC, LMFT, RN (with BH experience), Board Certified Behavioral Analyst (BCBA) or Board Certified Behavior ... behavioral health providers. The incumbent is responsible for utilization management, quality reviews and monitoring activities of BHT services. The incumbent will… more