- CVS Health (Columbus, OH)
- …and implements data-driven strategies/interventions that ensure the delivery of time sensitive behavioral health benefits and services for members. The QM BH ... and supports the development of HEDIS interventions and initiatives within the Quality Management Team. The QM BH Consultant reviews documentation and… more
- CVS Health (Columbus, OH)
- …issues. * Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the ... established channels * Ability to speak to medical and behavioral health professionals to influence appropriate member...care to meet the member's goals * Utilizes case management and quality management processes… more
- CVS Health (Columbus, OH)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... established channels. + Ability to speak to medical and behavioral health professionals to influence appropriate member...care to meet the member's goals. + Utilizes case management and quality management processes… more
- Elevance Health (Columbus, OH)
- …in technology product management , product development, market strategy, healthcare or behavioral health consulting, BH program management , and Market ... Product Management Senior Director serves a critical role on the Carelon Behavioral Health (BH) Product and Strategy team. Working with our BH business, this… more
- Elevance Health (Columbus, OH)
- ** Behavioral Health Outreach Care Specialist** **Location** : This is a **hybrid** role. Associates will be working from home and out in the community (up to 40% ... : Monday - Friday 8:00am - 5:00pm EST The ** Behavioral Health ** **Outreach Care Specialist** is responsible...cases and for proactively identifying ways to improve the health of our members and meet quality … more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- CVS Health (Columbus, OH)
- …executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company standards to maintain ... + 7-10 years work experience in a provider contracting role, Medicaid and/or behavioral health experience preferred. + Proven working knowledge of physician… more
- Public Consulting Group (Columbus, OH)
- …a Senior Consultant in Medicaid policy and funding as it relates to children's behavioral health services and child welfare and juvenile justice services. This ... welfare, juvenile justice, early childhood, childcare, children's disability services, and children's behavioral health services. PCG is looking for a Senior… more
- Humana (Columbus, OH)
- …Leader will lead a transformative effort to define our future-state operating model for Behavioral Health to improve health outcomes, reduce medical costs, ... outcomes, as opposed to services performed, which can improve health , boost quality , and control costs. Finally,...responsible for developing and deployment of a new, end-to-end Behavioral Health model at Humana, balancing access,… more
- CVS Health (Columbus, OH)
- …The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral ... consults with case managers, supervisors, Medical Directors and/or other health / behavioral health programs to overcome...Monitoring, Evaluation and Documentation of Care: o Utilizes case management and quality management processes… more
- CVS Health (Columbus, OH)
- …Excellence) plan is a Medicaid managed care program that provides and coordinates behavioral health care for eligible children and youth. The Manager, Clinical ... Services strategies, policies, and programs are comprised of utilization management , quality management , network ...RN, LPPC, LPPC-S, LISW, LISW-S) **Education** Master's degree in behavioral health field; or Registered Nurse (BSN… more
- CVS Health (Columbus, OH)
- …/ Managed care experience preferred. **Education** + LPN or bachelor's degree in behavioral health or health care related field (psychology, social ... and promote lifestyle/behavior changes to achieve optimum level of health . + Documentation of Care: Utilizes case management...Wood** . + 2 years' LPN experience or in behavioral or physical health , social services, or… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …Wylie VA Ambulatory Care Center (VA ACC) in Columbus, Ohio, under the Behavioral Health Service within the Community Outreach Division. The incumbent functions ... and compilation of peer review materials and creation of quality improvement tools and methods. Data Management ...staff, Knowledge of the principles of process improvement and quality assurance in health care, Ability to… more
- CVS Health (Columbus, OH)
- …with the Behavioral Health , Pharmacy, member outreach, Care Management , National Quality Management , Utilization Management , Compliance, ... health populations to optimize risk adjustment, clinical quality , and care management . * Actively participate...departments to integrate social, behavioral , and physical health and improve clinical program execution. * In collaboration… more
- CenterWell (Columbus, OH)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** The Care Delivery Call Quality ...to seniors, including wellness visits, physical exams, chronic condition management , screenings, minor injury treatment and more. Our unique… more
- CVS Health (Columbus, OH)
- …including after-hours consultation as needed. * Leading all major clinical, population health management , and quality improvement components of the ... Management committee and of the OhioRISE Plan's internal quality improvement committee. * Play a lead role in...* At least five years of experience with children's behavioral health services. * Must be a… more
- AmeriHealth Caritas (Dublin, OH)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... **Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin,...now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate… more
- Highmark Health (Columbus, OH)
- …range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizes data/analytics, ... over specified panel of members by performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address… more
- Humana (Columbus, OH)
- …Improvement, Utilization Management , Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Long-Term Services and Supports, ... information. **Preferred Qualifications** + MBA programs with a specialization in Healthcare Management **OR** Master's Degree in Public Health programs. +… more
- Humana (Columbus, OH)
- …Utilization Management , Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Institutional Long-Term Services and ... Managed Care Organization (MCO) focusing on Medicaid clinical strategy and population health management strategy. **Alternatively** **,** 5+ years of experience… more