- Buckeye Community Health Plan (Thornville, OH)
- …Board certification in general psychiatry or child psychiatry. 5+ years of experience working in behavioral health managed care or behavioral ... implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or… more
- WellSpan Health (York, PA)
- …or uncompensated care . Provides support to multiple provider types in behavioral health authorization process. Performs a variety of functions including, but ... 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health ...nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and… more
- Centene Corporation (Columbus, OH)
- …Board certification in general psychiatry or child psychiatry. + 5+ years of experience working in behavioral health managed care or behavioral ... of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, or unusual… more
- Molina Healthcare (Santa Fe, NM)
- …in a behavioral health setting, and preferably Medicaid managed care experience, or equivalent combination of relevant education and experience. ... (RN) license. * Clinical practice experience with a behavioral health entity or managed care organization. * Experience in discharge planning, home … more
- Ventura County (Ventura, CA)
- …through division managers, a comprehensive system of integrated behavioral health services, managed care operations and administrative services; ... Care Agency. It can be distinguished from other behavioral health classifications by the broad span...control, data evaluation, best practices of behavioral health program planning and administration including managed … more
- Molina Healthcare (Eau Claire, WI)
- …or Registered Nurse (RN) license. * Clinical practice experience with a behavioral health entity or managed care organization. * Experience in discharge ... Provides lead level support for team supporting integrated behavioral health /chemical dependency services and long-term care for members with high-need… more
- Saint Francis Health System (Tulsa, OK)
- … behavioral health care , part of which may be experience in Behavioral health managed care . Knowledge, Skills and Abilities: Working knowledge ... of patients, matching the level of care utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures… more
- Blue KC (MO)
- …or more years of progressive experience in population health , behavioral health integration, or managed care strategy within a payer or provider ... This role ensures behavioral health , health outcomes, and whole person care are...5+ years of experience in integrated care , managed care , or population health … more
- Centene Corporation (Mcallen, TX)
- … health hospital, community mental health , substance abuse/ detox recovery treatment, managed care behavioral health , or state social services ... complex and high risk members with mental/ behavioral health needs, and recommends a plan of care...experience is required **Preferred Experience:** * 3+ years of behavioral health case management, care … more
- Elderwood (Buffalo, NY)
- …with a frail or elderly population and/or members with chronic illness or behavioral health issues. + Previous Managed Care experience, within a MLTC or ... coaching and education to members and their caregivers on health care related issues + Provide discharge...home care , case management, discharge planning or managed care . + Minimum of one (1)… more
- WellSpan Health (Mount Gretna, PA)
- …and Accreditation, Risk Management, billing) and provides oversight to behavioral health support departments ( Managed Care Specialist team and Central ... **General Summary** Provides leadership and oversight of the behavioral health ambulatory service line to...within the organization. + Ensures the provision of affordable health care services by the acquisition, partnership,… more
- Elevance Health (Jacksonville, NC)
- … health services. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + Travels ... system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families...of integrated (physical and behavioral ) whole person care . + Coordinates social determinants of health … more
- Elevance Health (Shelby, NC)
- … health services. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. **We are ... system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families...of integrated (physical and behavioral ) whole person care . + Coordinates social determinants of health … more
- Elevance Health (Greensboro, NC)
- …for this position. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. **We are ... system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families...CFSP Care Management model which includes physical health , behavioral health , and social… more
- CVS Health (Baton Rouge, LA)
- …per our company expense reimbursement policy. **Preferred Qualifications** + Behavioral health experience + Managed care /utilization review experience + ... and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we… more
- Elevance Health (Charlotte, NC)
- …very strongly preferred. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + ... by the child welfare system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP), and… more
- Molina Healthcare (Scottsdale, AZ)
- …Certified Case Manager (CCM). Experience with Behavioral Health / Psych hospital Care Management and Managed care To all current Molina employees: If ... , preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.… more
- Humana (Indianapolis, IN)
- …Qualifications** + Familiarity with Illinois -based BH organizations + Medicaid Managed Care clinical or behavioral health leadership experience + Reside ... of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health...for contracted primary care Providers (PCPs) treating behavioral health ‐related concerns not requiring referral to… more
- CVS Health (Rocky Mount, VA)
- …Virginia state licensure required. - 3 years clinical experience (med surg, behavioral health ) - 2+ years Managed Care experience. - Must reside in ... and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we… more
- Elevance Health (Mason, OH)
- …and Experiences:** * Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. * ... competent, person‐centered coordination for all members that addresses physical health , behavioral health , long term...overseeing a team responsible for coordination of OH My Care comprehensive health care program… more
