- Molina Healthcare (Louisville, KY)
- …KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and inpatient services for the KY ... speed required. JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying… more
- UCLA Health (Los Angeles, CA)
- Description The Public Mental Health Partnership (PMHP) is seeking to hire a full-time Clinical Quality Analyst (CQA) to conduct fidelity reviews for ... as a California Center of Excellence (COE) under the BH -CONNECT Initiative. The CQA will conduct fidelity reviews on-site...quality assurance, quality improvement, and/or data-driven quality monitoring processes in clinical settings +… more
- Commonwealth Care Alliance (Boston, MA)
- …Provider Contracting department and will have regular interaction with relevant internal Clinical , Quality , and BI departments, while frequently interfacing with ... for Mental Illness (FUH) data:** + Work with BI, Quality , and BH teams to evaluate and...Network on the measures** + Organize trainings, working with Quality and Clinical teams to build reference… more
- SSM Health (MO)
- …Type:** Regular **Job Highlights:** Exciting Opportunity for an Epic Systems Analyst at SSM Health! Required certifications are EpicCare Ambulatory, Inpatient ... Clinical Documentation, or Procedure Orders. Preferred certifications are Beacon...reports for multiple Epic applications. Tests build to ensure quality delivery to business partners. + Implements and stabilizes… more
- Providence (AK)
- …Results: Set and achieve goals aligned with organizational mission, quality , budget, and customer expectations **Your Superpower? Collaboration.** You'll forge ... Epic Certification + Certifications in software applications, technology infrastructure, or clinical specializations + 4 or more years of AthenaIDX, EDM, Informatics… more
- Centene Corporation (Phoenix, AZ)
- …level of care and services are medically appropriate related to behavioral health ( BH ) and/or autism spectrum disorder needs and clinical standards + Performs ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...accordance with ABA regulatory guidelines and criteria + Analyzes BH member data to improve quality and… more
- Elevance Health (Las Vegas, NV)
- …Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental health and substance use disorder management, a comprehensive employee ... an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access...assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in… more
- Elevance Health (Winston Salem, NC)
- …companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive ... limited to:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access...assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in… more
- Texas Health Resources (Arlington, TX)
- …so we are Better + Together_ ** This role supports Ambulatory (THPG, THUC, BH Virtual) Clinical and Professional Billing reporting and analytics. ** Work ... or Epic Reporting environments. + Work with the DBA, ETL Architect, Business Analyst , and Data Architect to make changes to existing data marts, warehouse… more
- Elevance Health (Indianapolis, IN)
- …companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive ... for members with behavioral health needs. Subject matter expert in targeted clinical areas of expertise such Autism Spectrum Disorders (ASD). Candidates with BCBA… more
- Elevance Health (Los Angeles, CA)
- …you will make an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary ... quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as appropriate.… more
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