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Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... work closely with the Quality Director, Behavioral Health Director, Quality Improvement Manager and those ... support pieces - i.e. Transitional Case Management documentation) Develops collateral documentation ... Qualifications Bachelor's..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
... The Lead Behavioral Health Medical Director oversees the work of 2 ... Medical Directors who conduct clinical case reviews of the care received ... portion of their time doing..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston ... West Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director,..
Description The Medical Director actively uses their medical background, ... daily work. Responsibilities The Medical Director's work includes computer-based review of ... within their scope. The Medical Director may speak..
Description The Medical Director relies on fundamentals of CMS ... Line of Business. The Medical Director provides medical interpretation and determinations ... whether services provided by other healthcare professionals are..
Job Information Humana Director, Behavioral Health Strategy in Charleston ... Charleston West Virginia Description The Director, Behavioral Health (DBH) will ensure ... their behavioral health needs. The Director, Behavioral Health..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... daily work. Responsibilities The Medical Director provides medical interpretation and decisions ... of services provided by other healthcare..
