- UNC Health Care (Hendersonville, NC)
- …for behavioral health services. Working closely with behavioral health clinicians, utilization review, case management , and finance teams, the ... or a related health field. Minimum 2 years of experience in behavioral health , care coordination, case management , or hospital-based social services.… more
- AmeriHealth Caritas (Newtown Square, PA)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services,… more
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
- AmeriHealth Caritas (Newtown Square, PA)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,… more
- Elevance Health (Winston Salem, NC)
- Utilization Management Representative I Location : This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law. The Utilization Management Representative I is responsible for...training and experience in medical or insurance field preferred. Behavioral health medical terminology strongly preferred. For… more
- AmeriHealth Caritas (Newtown Square, PA)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... with providers and appropriate others to facilitate and coordinate the Utilization Management process(es) activities. Utilize technology and resources (systems,… more
- Highmark Health (Little Rock, AR)
- …(Tuesday-Thursday). This role supports the full application product lifecycle for clinical and utilization management software , with a specific focus on driving ... function as a pivotal bridge, translating high-level clinical and utilization management software business needs into detailed...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Banner Health (Scottsdale, AZ)
- …business administration, health services administration or related field. Requires (1) Behavioral Health clinical degree with a related Master's degree (ie ... decisions and budgets. Must be highly computer literate. Employees working at Banner Behavioral Health Hospital, BTMC Behavioral , and BUMG, BUMCT, or… more
- Commonwealth Care Alliance (Boston, MA)
- …available to support dual eligible populations Experience in behavioral health clinical practice, provider relations, or healthcare management Desired ... 011230 CA-Provider Engagement & Performance Position Summary The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating… more
- Highmark Health (Monroeville, PA)
- Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This position is responsible for the strategic implementation of supply chain initiatives and ... operational management throughout AHN hospitals and surgery centers. The Materials...multiple complex supply chain activities within acute and ambulatory health care institutions. Provides supervision to the various Material… more
- CVS Health (Phoenix, AZ)
- …goals. The role of the MTM Pharmacist is to deliver telephonic medication therapy management (MTM). Effective delivery of this CVS Health telephonic based MTM ... At CVS Health , we're building a world of health...pharmacist licensure within their state of residence. Medication Therapy Management supports the company vision to help people on… more
- Premise Health (Pleasanton, CA)
- …time, a company-sponsored wellness program, EAP, access to virtual primary care and virtual behavioral health at no cost for team members and their dependents. ... hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com. As a… more
- Highmark Health (Blue Bell, PA)
- …or equivalent training (Residency) 5 years of Experience in managed care, pharmacy benefit management (PBM), or health plan setting. 3-5 years in health ... in Quality Improvement 3 - 5 years in Care Management 3 - 5 years in Utilization ...Utilization Review 3 - 5 years in the Health Insurance Indus Master's Degree in Health … more
- The Cigna Group (St. Louis, MO)
- …for existing clients with close attention to detail and accuracy Review custom Utilization Management policies for rebate eligibility or adherence to contract ... from manager and in close partnership with business partners Support standard utilization management review as needed Create client presentations and present… more
- Banner Health (Tucson, AZ)
- …internal and external customers. Manages data as related to operations. Performs Utilization Management functions as required by facility CORE FUNCTIONS Acts ... be proficient with commonly used office software and equipment. Employees working at Banner Behavioral Health Hospital, BTMC Behavioral , and BUMG, BUMCT, or… more
- WellSpan Health (York, PA)
- …providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. ... sense of diplomacy, including strong negotiation, conflict resolution, and people management skills. WellSpan Health 's vision is to reimagine healthcare… more
- Highmark Health (Little Rock, AR)
- …positively impact corporate performance Researches, manipulates, and prepares data related to Health Management programs that document program activities and the ... the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The...results of Health Management interventions and initiatives. Project … more
- Banner Health (Gilbert, AZ)
- …familiarity with Alzheimer's disease and developmental disabilities. Employees working at Banner Behavioral Health Hospital, BTMC Behavioral , and BUMG, ... the unit to ensure smooth and efficient patient care management and resource utilization . Leads change by...BUMCT, or BUMCS in a Behavioral Health clinical setting that serves children must possess an… more
- WellSpan Health (Chambersburg, PA)
- …providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. ... effectively manager cost and maximize employee satisfaction and resource utilization . Duties and Responsibilities Essential Functions: Facilitates and directs… more
- Banner Health (Sun City West, AZ)
- …in cardiac services, women's health and maternity, robotic surgery and orthopedics, behavioral health , and critical care to name just few. In addition, we ... for coverage under the company's auto insurance policy. Employees working at Banner Behavioral Health Hospital must possess an Arizona Fingerprint Clearance Card… more
