- Humana (Providence, RI)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral ... documentation, and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health… more
- CenterWell (Providence, RI)
- …education spanning onboarding to continuing education. **Role Description** The LCSW Behavioral Health Educator will be embedded within the clinical education team ... and will oversee training aspects of the cognitive behavioral health screenings, psychosocial assessments, techniques that can be...has a deep understanding of all the High-risk program management roles and gains the respect and confidence of… more
- Hartford HealthCare (Danielson, CT)
- …May assume clinical oversight of daily operations in the absence of Program Manager . Key responsibilities of Lead Behavioral Health Clinician: * Conducts a ... We offers a variety of programs including inpatient and outpatient behavioral health, residential treatment for court-involved teenage girls, geriatric services,… more
- Highmark Health (Providence, RI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Highmark Health (Providence, RI)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- Charter Care Health Partners (North Providence, RI)
- …in acute behavioral health. Utilization review and inpatient behavioral health experience preferred. Computer database management experience and case ... Summary: Under the Direction of the System Manager , the Lead BH Inpatient Social Worker is...on the unit. Performs functions related to Patient Advocacy; Utilization Review; Resource Management ; Continuum of Care… more
- CenterWell (Providence, RI)
- …systems to improve staff productivity and workload efficiency. + Project management and problem solving. Solve problems through critical evaluation of data-based ... by accessing and understanding formulary restrictions, plan limitations, drug utilization review overrides, requesting and completing prior authorization, and/or… more
- CenterWell (Providence, RI)
- …by accessing and understanding formulary restrictions, plan limitations, drug utilization review overrides, requesting and completing prior authorization, and/or ... patients afford their medications. + Assist clinical pharmacists with disease management scheduling, pre-appointment preparation, and follow up tasks for medication… more
- Sevita (Taunton, MA)
- …including clinical team meetings and regularly scheduled supervision meetings + Coordinate utilization with the Case Manager relative to program participant's ... account + Organize and facilitate internal medical appointments as requested by management , overseeing timely completion of annual medical appointments + Ensure the… more