Your Role The Behavioral Health (BH) Utilization Management (UM) team manages prior authorization and concurrent review for members seeking mental health and/or substance use disorder treatment. The Operations Specialist, Experienced will report to the Sr. Manager, BH UM. In this role you will be the subject matter expert for the BH UM team with projects and deliverables that support business needs for our Fully Insured products.Your Work In this role, you will: Act as a subject matter expert to review operational workflows of high degree of complexity, identifying problems and developing improvements, modifications, and enhancements Work with business leaders to identify requirements and make recommendations Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff May be responsible for entire projects or processes within job area Track and communicate workflow and system changes to appropriate sources and coordination of training and documentation needs Notifies appropriate managers on issues and problems requiring immediate attention and provides recommendations for resolution Responsible for improving processes to enhance performance of the job area Develop and generate reports ranging from routine to moderately complex for management review Identify and implement process enhancements and efficiency gains that can be realized on an ongoing basis Support testing to ensure system functionality Maintain ongoing relationships with vendor partners to ensure compliance with regulations, SLAs and performance Your Knowledge and Experience Requires practical knowledge of Utilization Management functions including prior authorization/concurrent review Requires a college degree or equivalent experience Requires 3 years of prior relevant experience Understanding of behavioral health facility-based levels of care preferred Experience with Prior Authorization preferred Experience working with project management and business change readiness preferred Strong written and verbal communication skills Strong critical thinking skills and attention to detail
...member of the Confluent Health family of physical and occupational therapy companies that is transforming healthcare by developing... ...development pathways to become industry leaders. Pediatric Occupational Therapist Assistant Full Time: 30-40 Hours Per Week Salary...
Looking for a NP/PA job? My name is Leah and I"m a healthcare recruiter, I"m here to help! I have a new Neonatal Nurse Practitioner/Physician Assistant position available near Boston, Massachusetts! Details- Full-time and permanent- Shift: PA - 36hrs 3x12sNP - 24 hrs OR...
DescriptionSummary:PRN Neonatal Nurse Practitioner- CHRISTUS-LongviewMalpractice Insurance Epic EMRCHRISTUS Trinity Clinic and CHRISTUS Physician Group are multi-specialty medical groups with more than 850 Physicians and Advanced Practice Providers. Our clinicians...
...provide services to applicants and companies coast to coast. Responsibilities Answer incoming calls and conduct telephone interviews with pre-employment applicants as part of their background screening process Engage with pre-employment applicants via text, email...
...The Security Supervisor of Overbrook School for the Blind exudes a passion for the school, its students, and its employees. This position... ...a bright future. Job Functions: The security supervisor manages the security and patrol of a school building to ensure a safe and...