- Elevance Health (Denver, CO)
- …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...clinical reviews. + The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and… more
- The Cigna Group (Denver, CO)
- …of 2 years of experience in a behavioral managed care organization, including utilization management and case management . Prior strategic management ... Manager is an externally facing market representative for Cigna's Behavioral Health products, services and solutions. The...will be able to educate others on the clinical utilization review process, denial and appeals process, and network… more
- Intermountain Health (Wheat Ridge, CO)
- …Benefits Eligible: Yes + Full-time, 36 hrs./per week + Unit/Location: West Pines Behavioral Health ; Wheat Ridge, Colorado Scope 1.Maintains competency to deliver ... the RN position description. 2. Embraces technology. Demonstrates competency in the utilization of the EMR. Utilizes technology to enhance efficiency. Competent in… more
- University of Colorado (Aurora, CO)
- Regional Director of Clinical Operations - Primary Care and Behavioral Health - 34131 University Staff **Description** **University of Colorado Anschutz Medical ... **Job Title: Regional Director of Clinical Operations - Primary Care and Behavioral Health ** **Position #: 00782442 - Requisition #:34131** **Job Summary:**… more
- The Cigna Group (Denver, CO)
- …several health -related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, ... experience. + Intimate knowledge of managed care operations and facility network management in behavioral and/or medical with experience with commercial and… more
- CenterWell (Denver, CO)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as… more
- Highmark Health (Denver, CO)
- …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
- Highmark Health (Denver, CO)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
- Highmark Health (Denver, CO)
- …that includes weekend coverage. This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Intermountain Health (Lafayette, CO)
- …payor models. 7. Provides education to patients, caregivers, and patient representatives on health management and community resource utilization . 8. Attends ... for patients identified as needing assistance or meeting Care Management criteria to ensure health care continuity,... needs and complex family dynamics. 4. May conduct behavioral health assessments, crisis counseling, behavioral… more
- Intermountain Health (Denver, CO)
- …payor models. + Provides education to patients, caregivers, and patient representatives on health management and community resource utilization . + Attends ... for patients identified as needing assistance or meeting Care Management criteria to ensure health care continuity,... needs and complex family dynamics. + May conduct behavioral health assessments, crisis counseling, behavioral… more
- Elevance Health (Denver, CO)
- …care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational ... Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud...for multiple managed conditions to ensure cost-effective and efficient utilization of health services. Conducts assessment, planning,… more
- HCA Healthcare (Aurora, CO)
- …acute care setting required + Broad experience in a healthcare setting. + Five years management experience in a Behavioral Health acute care setting and/or ... We are seeking a Director of Clinical Services for Behavioral Health with The Medical Center of...treatment/therapy, case management , discharge planning, budgeting, quality management , utilization management and team… more
- Elevance Health (Denver, CO)
- …projects and initiatives. **Requirements:** + Requires MA/MS social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 ... services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with… more
- HCA Healthcare (Englewood, CO)
- …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 ... hours volunteering in our communities. As a Director Case Management with Swedish Medical Center you can be a...Center offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Denver, CO)
- …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 ... Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...+ You will consult with facility-level staff regarding delegated utilization management and disease management … more
- HCA Healthcare (Englewood, CO)
- …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 ... where diversity and inclusion thrive? Submit your application for our Materials Management Coordinator opening with Rocky Mountain Surgery Center today and find out… more
- University of Colorado (Aurora, CO)
- …Director, the Residential Coordinator, Primary Substance Use Disorder Counselors, and Behavioral Health Technician staff. This position evaluates the mental ... Mental Health Therapist - 32367 University Staff **Description** **University...dually diagnosed patients. + Well-developed knowledge and skill in utilization and diagnosis using DSM V, Axis II and… more
- Highmark Health (Denver, CO)
- **Company :** Highmark Health **Job Description :** Job Description **JOB SUMMARY** This role within the marketing & experience department will be at the forefront ... includes leveraging cutting-edge customer experience platforms, implementing robust data management solutions, and optimizing marketing automation tools to drive… more
- HCA Healthcare (Greenwood Village, CO)
- …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 ... role:** Supervises, monitors, and ensures competencies and performance of assigned home health care team(s) Supervises ongoing case management of all patients… more