- Humana (Richmond, VA)
- …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 (Richmond, VA)
- …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, … more
- Evolent (Richmond, VA)
- …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
- LifePoint Health (Danville, VA)
- …delivery network committed to/making communities healthier/(R)with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your ... *Registered Nurse, RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000...Comprehensive medical, dental, and vision plans, plus flexible-spending and health - savings accounts . Competitive paid time off and… more
- Elevance Health (Norfolk, VA)
- …companies, Carelon Behavioral Health , offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance ... and insightful analytics to improve the delivery of care._ ** Behavioral Health Care Manager II - Applied...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Highmark Health (Richmond, VA)
- …Time - Weekends Required.** This job implements the 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...years of post licensure experience in a combination of Behavioral Health Clinical, Case Management … more
- CVS Health (Richmond, VA)
- …positive outcomes and enhance overall well-being. **What you will do** + Coordinates behavioral health assessments to gain information on substance abuse history ... measurable outcomes. + Configures electronic medical software to categorize behavioral health conditions by severity. + Edits...to deliver an impactful message surrounding client rights and health needs. + Examines the data management … more
- Bon Secours Mercy Health (Portsmouth, VA)
- …and operational excellence. **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care provider ... Collects and records nursing assessment of the physical and behavioral health status of the patient. *...patient outcomes are met. * Participates in the safe management of the milieu, intervening effectively with patients who… more
- Elevance Health (Norfolk, VA)
- **JR136086 Behavioral Health Provider Quality Manager** Responsible for leading Behavioral Health (BH) provider engagement, with a focus on leveraging ... quality outcomes. + Analyzes provider reports pertaining to cost, utilization , and outcomes, and presents the data to providers...applicable. **Minimum requirements:** + Requires MA/MS or above in Behavioral Health field and minimum of 10… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- Behavioral Health Senior Clinician - Residential Treatment & Detox Services Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4762354) ... Apply Behavioral Health Senior Clinician - Residential Treatment...and supports admissions to the program. + Coordinating with Utilization Management (UM) to complete service authorization… more
- HCA Healthcare (Richmond, VA)
- …Do you want to join an organization that invests in you as a(an) Behavioral Health Pract PRN? At Chippenham Hospital, you come first. HCA Healthcare ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...next level of care. + Has working knowledge of utilization management functions and performs these duties… more
- Veterans Affairs, Veterans Health Administration (Chesapeake County, VA)
- …Care Network (VISN 6), Hampton (HVAMC).This position is aligned under the Behavioral Health Interdisciplinary Program (BHIP)/Outpatient Services and will serve ... Summary This position is located within the Veterans Health Administration (VHA), VA Mid-Atlantic Health ...to patients; patient satisfaction activities; patient safety and risk management activities; and utilization management .… more
- Humana (Richmond, VA)
- …community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' ... care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied... of Pedatric member's (Under 21) who utilize Applied Behavioral Analysis (ABA Services). Monitor/have awareness of utilization… more
- US Marine Corps (Quantico, VA)
- … program. Implements policies, conducts screenings, clinical counseling services and case management services for Behavioral Health Branch programs. Serves ... marital, group, and family treatment. Reviews, develops, coordinates and provides case management services concerning Behavioral Health participants to… more
- Elevance Health (Richmond, VA)
- …The **Medical Director** will be responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years...+ Background in Internal Medicine is strongly preferred. + Utilization management experience is a PLUS. Please… more
- Elevance Health (Norfolk, VA)
- …as related to oncology drivers. Responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Director** will be supporting our clients in operations with utilization and case management reviews. In addition,...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Highmark Health (Richmond, VA)
- …:** **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 (Richmond, VA)
- …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 (Richmond, VA)
- …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For… more
- Highmark Health (Richmond, VA)
- …:** **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