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American multinational healthcare company
Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service…
Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical…
Position Purpose: Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan…
Position Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and…
Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are…
Position Purpose: Provides expertise based on experience with identifying, overseeing, and managing the coordination of transition of members in the community. Works with leadership to address complex issues and…
Position Purpose: Assist the CMO to direct and coordinate the physician component of the utilization management functions for the health plan business units. Key Details: Must be Board Certified Physician with an…
Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's…
Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved.…
Position Purpose: Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality,…
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including…
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