- AdventHealth (Glendale Heights, IL)
- …health care services regarding admissions, case management , discharge planning and utilization review for Behavioral Health **The value you'll bring to the ... Oversees and coordinates compliance to federally mandated and third-party payer utilization management rules and regulations. Qualifications **The expertise and… more
- Elevance Health (Norfolk, VA)
- …PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- State of Minnesota (St. Paul, MN)
- …Title: School-Linked Behavioral Health Data Analyst** **Job Class: Research Analysis Specialist Senior** **Agency: Human Services Dept** + **Job ID** : 83348 ... School-Linked Behavioral Health (SLBH) program evaluation and provide consultation to management on major behavioral health policy and budget changes. The… more
- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** This position is on-site. **Job Description:** The Utilization Analyst works with physicians, the payers and inpatient case ... management team to validate the medical necessity of the...necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these… more
- US Tech Solutions (Columbia, SC)
- …from your internet provider (non-satellite). + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Ability to process authorization… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/ analysis , ... medical policies. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/ analysis , ... mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years… more
- Centene Corporation (Tallahassee, FL)
- … behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of ... PCP's) and groups identified that are participating in Physical/ Behavioral integration activities. + Works with utilization ,...Physical/ Behavioral integration activities. + Works with utilization , case and disease management teams to… more
- UPMC (Moosic, PA)
- …consultation with practitioners in the field. This includes significant responsibility for quality management and utilization management and for assuring the ... you will assure the quality and efficiency of the behavioral health care delivered to Community Care members. Incorporated...protocols. + Review the medical aspects of cost and utilization reports generated by Medical Management Information… more
- CVS Health (Trenton, NJ)
- …role requires experience and familiarity with Substance Use Disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered services, ... the plan and works across various departments including Care Management , Utilization Management , Quality ... Management , Quality Management , and Medical Management on issues related to Behavioral Health.… more
- Immigration and Customs Enforcement (Jena, LA)
- …manage serious mental illness (SMI) caseload. Provides on-site counseling, psychotherapy, behavioral analysis , substance abuse education, and therapy as ... Service Corps (IHSC), Office of the Deputy Assistant Director of Clinical Services, Behavioral Health Unit. This position is supervisory. This position is only open… more
- Ventura County (Ventura, CA)
- …operational need and certification of skill. DEPARTMENT/AGENCY: Health Care Agency - Behavioral Health Staff/Services Manager III is a Management classification ... Behavioral Health Informatics & Electronic Health Record Manager...tools + Principles and techniques of budgetary preparation and analysis , fiscal management , organization and staffing +… more
- Magellan Health Services (Albuquerque, NM)
- …the delivery of appropriate health care by overseeing the service coordination, utilization management , care/case management , population health/disease ... cost of care of clinical programs through review and analysis of utilization and financial data., Assists...overseen by the assigned position which includes metrics for utilization and quality management . Develops mitigating strategies… more
- Magellan Health Services (San Diego, CA)
- …appropriate for complex case management and timely completion of all utilization management activities. Involvement in the development of case management ... plans. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Dartmouth Health (Keene, NH)
- …physician practice, while emphasizing care coordination across the continuum. Perform utilization management activities as necessary to ensure that medical ... Functioning as a member or the Behavioral Health Team, the Master's Level Clinician, in...critical pathways and outcome measurement preferred. Experience in case management , utilization review and discharge planning preferred.… more
- Centene Corporation (Tallahassee, FL)
- …abuse across the continuum of care. Experience with managed care, case management , utilization management , or quality improvement. **License/Certification:** ... review of member clinical records and services related to behavioral health and substance use. + Interpret and present...member satisfaction + Serve as resource and liaison on utilization , quality improvement and case management activities… more
- LifePoint Health (Hickory, NC)
- Job Summary The Behavioral Health Clinical Program Therapist functions as a member of the Behavioral Health Team in providing independent practice license scope ... levels of psychiatric care for the patients on the Behavioral Health Units. Provides and documents mental health services to Psychiatric patients. Develops and… more
- University of Miami (Miami, FL)
- … Sciences generates, manages, and interprets strategic information; provides financial management and accountability for all Psychiatry & Behavioral Sciences ... opportunity for a Full-time Sr. Administrative Officer, Psychiatry & Behavioral Health Sciences to work in Miami. The Sr....the business of the Department. + Oversees the administrative management of clinical programs to include analysis … more
- Hartford HealthCare (Meriden, CT)
- …and operational activities of services provided at Rushford. Supervises the clinical management teams of these services, with a focus on clinical excellence, ... evidence-based practice, strategic growth, quality analysis , program development, implementation, and stability. *Job Responsibilities* 1. Utilizes lean principles… more
- Point32Health (MA)
- …Health functions as a key member of the Program Coordinator Team and the BH Utilization Management department and is a representative of Point32 Health values to ... (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the direction of the Supervisor - Behavioral Health is responsible for the daily management of… more