- Humana (Nashville, TN)
- …help us put health first** Humana Healthy Horizons in Kentucky 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
- Evolent Health (Nashville, TN)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake … more
- The Cigna Group (Nashville, TN)
- …clinical and administrative techniques associated with integrated health trends, case management and utilization management to generate new innovative ... years' experience in the healthcare field; strong focus on behavioral health or EAP + Bachelor's degree...industry to include an understanding of managed care, care management , disease management and health … more
- HCA Healthcare (Nashville, TN)
- …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 ... management experience preferred. 1. Certification in case management , nursing, or utilization review preferred. 1....facility. We offer medical and surgical programs. These include behavioral health and 24-hour emergency. These also… more
- HCA Healthcare (Nashville, TN)
- …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... Management experience preferred + Certification in Case Management , Nursing, or Utilization Review, preferred +… more
- HCA Healthcare (Brentwood, TN)
- …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 ... program director, faculty, residents, faculty and medical students in the utilization of relevant information technologies, information management tools and… more
- HCA Healthcare (Nashville, TN)
- …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 ... have the career opportunities as an AVP Medical Device Management you want with your current employer? We have...HealthTrust, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Elevance Health (Nashville, TN)
- …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 (Nashville, TN)
- …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 ... supporting a balance of optimal care and appropriate resource utilization . Provides case management services for...facility. We offer medical and surgical programs. These include behavioral health and 24-hour emergency. These also… more
- Highmark Health (Nashville, TN)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Elevance Health (Nashville, TN)
- …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and accurate… more
- Elevance Health (Nashville, TN)
- …that are enabled across Carelon's Product Portfolio, inclusive of medical benefits management products, behavioral health products, payment integrity ... products, pharmacy benefit management products, specialty risk products, utilization management and prior authorizations. This Director will look across the… more
- Highmark Health (Nashville, TN)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- HCA Healthcare (Nashville, TN)
- …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...supporting a balance of optimal care and appropriate resource utilization . + Provides case management services… more
- HCA Healthcare (Smyrna, TN)
- …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...supporting a balance of optimal care and appropriate resource utilization . . provides case management services for… more
- HCA Healthcare (Nashville, TN)
- …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 ... Do you have the career opportunities as a Change Management Analyst you want with your current employer? We...Healthcare offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- HCA Healthcare (Nashville, TN)
- …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 ... you have the career opportunities as a Manager Case Management you want with your current employer? We have...Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- Elevance Health (Nashville, TN)
- … health care program in which members' needs are identified, including physical health , behavioral health , social services for a special product/programs ... Skills, Capabilities and Experiences:** Service delivery coordination, discharge planning, or behavioral health experience in a managed care setting preferred.… more
- HCA Healthcare (Nashville, TN)
- …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...supporting a balance of optimal care and appropriate resource utilization . Provides case management services for… more
- LifePoint Health (Brentwood, TN)
- …Lifepoint's healthcare delivery network.Our network includes 60 community hospitals, 60 rehabilitation/ behavioral health hospitals, and 250 additional sites of ... **Director**Workforce Solutions- Remote *Who we are:* At Lifepoint Health , we provide quality healthcare to rural communities. As a valued member of our team, you… more