- Elevance Health (Topeka, KS)
- …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
- CVS Health (Topeka, KS)
- …for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... company policies and procedures + Non-exempt role. Required Qualifications + 1+ year(s) behavioral health , social services, or human services field. + Willing… more
- CVS Health (Topeka, KS)
- …for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... and company policies and procedures Non-exempt role. Required Qualifications -1+ year(s) behavioral health , social services, or human services field. -Willing… more
- CenterWell (Topeka, KS)
- …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 (Topeka, KS)
- …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 (Topeka, KS)
- …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
- Elevance Health (Topeka, KS)
- …such as coordination and management of an individual's waiver (such as LTSS/IDD), behavioral health or physical health needs. + Submits utilization ... in which a risk is identified related to the members LTSS, physical or behavioral health supports (including, but not limited to, potential for high-risk… more
- Elevance Health (Topeka, KS)
- …CST.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost ... for an entire clinical program. Will oversee all primary and physical and Behavioral Health Services provided to individuals receiving LTSS. Will also be… more
- Highmark Health (Topeka, KS)
- …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
- Elevance Health (Topeka, KS)
- …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
- Elevance Health (Topeka, KS)
- …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 (Topeka, KS)
- … health care program in which members needs are identified, including physical health , behavioral health , social services for a special product/programs ... **How you will make an impact:** + Manages resource utilization to ensure appropriate delivery of care to members,...and Experiences:** + Service delivery coordination, discharge planning or behavioral health experience in a managed care… more
- Highmark Health (Topeka, KS)
- **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
- Highmark Health (Topeka, KS)
- …actions (promotions, hiring, terminations, etc.) Develops talent, Addresses resource management , cultivates capabilities of staff, planning and coordination of work, ... in first-line resolution of complex technical problems 2. Provides Staff Management oversight * Hires, promotes, separates or makes recommendations regarding same… more
- Highmark Health (Topeka, KS)
- …and solutions to senior or lead engineers to further cloud service utilization and optimization. + Develops automation scripts and other repeatable patterns to ... of action. + Level 2 Incident, problem and change management as it pertains to the responsibilities of the...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- US Tech Solutions (Topeka, KS)
- …Healthcare. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... using care management tools and resources. **Required Experience** + 1+ year(s) behavioral health , social services, or human services field. + Willing and… more
- US Tech Solutions (Topeka, KS)
- …Healthcare. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management and ... with regulatory and accreditation guidelines and company policies and procedures **Education:** behavioral health , social services, or human services field. Case… more
- Sharecare, Inc. (Topeka, KS)
- …of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. ... team. Facilitates communication exchange with primary managing physician and other providers, health plan, and the disease management program team. + Coordinates… more
- CenterWell (Topeka, KS)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... leader will play a critical role in ensuring optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and… more
- Marriott (Topeka, KS)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... business systems (APIs, middleware tools etc.) + Understanding of environment management , release management , code versioning best practices, and deployment… more