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By leading market level projects and strategies for provider engagement, this position will drive optimal performance on quality, risk adjustment, utilization management, financial performance, and membership growth.
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Collaborate with other organizational departments responsible for functional aspects of the HIV Special Needs Plan, including, but not limited to Integrated Care Management, Behavioral Health, Managed Long-Term Care, Utilization Management, Quality Management, Credentialing, Regulatory Affairs, Compliance, Corporate Affairs, Provider Network Operations, Medicare Services, Information Systems, Finance, Claims, and Member Services and Eligibility.
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LMHC, EVP will join a team that offers leading Substance Abuse treatment including Detox, Residential, IOP/PHP, and First Responder services. Licensed Mental Health Counselor, LMHC or Licensed Clinical Social Worker, LCSW.
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Director Care Coordination- Major Responsibilities Criteria A: Establishes and coordinates communication with all Utilization Regulatory Agencies i.e. Qualidigm, NGS, etc., State and Third Party Payers to address Utilization Management Issues and Denials.
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A current, valid State of Florida license as a Licensed Mental Health Counselor (LMHC) or Licensed Clinical Social Worker (LCSW) or Licensed Marriage and Family Therapist(LMFT) is required. Licensed Counselor (LMHC or LCSW) - Substance Abuse Treatment.
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This experience typically includes: monitoring occupant space utilization, energy and water conservation, sustainability and environmental hazards programs; coordinating alteration and renovation projects; gathering information to assess the level of customer satisfaction, i.e., surveys, interviews with tenant contacts, focus groups; monitoring real property budgetary and financial data; and, administration of repair and/or operation and maintenance contracts.
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Master’s Degree in Social Work or related field; NYS LMSW, LMFT, LMHC, LCAT required. Instead of a congregate care setting, we place UCs in foster homes while we find and vet a sponsor for them to be unified with in the US. During their stay with us, we provide medical care, case management, life skills classes and mental health services.
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Participate in job-related committees, such as Substance Abuse, Utilization Management, Safety, and Risk Management. Supervise and assist clinicians in the use of formal and informal resources for the client, including transition, discharge, and aftercare plans of behavioral health services, outreach services, etc.
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Recent experience in case management, home health, utilization review, and or unit clinical specialty required. Requires current case management certification from either CCM, ACMA or RN-BC or must achieve within two (2) years of hire as a Case Management Coordinator.
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Qualifications: NYS LMSW; NYS LCSW; NYS LMHC, ;NYS LCAT ;NYS LMFT required. The Program Coordinator is responsible for the management and implementation of various program operations and functions that comprise an effective and successful program.
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Responsible for data and report generation of providers as well as regulatory agencies, as needed for Utilization Management activities. Utilizes Hospital Mainframe programs, CANOPY Care Management System, and TRAC effectively and coordinates updates with Insurance Verification, Social Work management, and Patient Accounts as appropriate.
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The Utilization Management Coordinator is responsible for all utilization management activities for assigned cases from admission through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with significant behavioral health needs and Autism Spectrum Disorders or other developmental disorders.
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Data Management: Oversee the collection, processing, and utilization of data for training the chatbot, ensuring sensitivity and compliance with data protection regulations. Minimum of 5 years of experience in cloud infrastructure design and management, with a strong focus on Microsoft Azure.
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Must hold Michigan licensure (LMSW, LCSW, LPC, LMFT, or LMHC), active associate number or intern number from the Board of Behavioral Sciences, in good standing. Located just north of Detroit, Troy is the largest community in Oakland County known for expansive parklands, Stage Nature Center, and historic Troy Village.
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LMSW, LMHC or other relevant, graduate degree is required. The FJC Advocate will provide direct counseling and emotional support, case management, and advocacy to criminalized survivors who seek services at the FJC(s) and serve as the resident criminalized survivor expert both at the FJC where they are stationed and within the broader network of all the City's FJCs.
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utilization management lmhc aftercare jobs Company: Metroplus Health Plan in New York, NY
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