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Utilization Management

Our Behavioral Health Utilization Management teams are licensed and/or certified experts in mental health and substance use disorders. Our team consists of psychiatrists, master level clinical social workers, registered nurses and psychiatrists with years of experience and extensive knowledge and training. The utilization management teams ensure members are receiving medically necessary services at the most appropriate level of care.

Learn About Utilization Management

Case Management Program

Our Behavioral Health Case Managers are experienced health care professionals who are available to engage telephonically and guide members through the complexities of the health care system to support their mental health and substance use disorder needs. Behavioral Health Case Management is available for Commercial, Medicare and Safety Net Lines of Business.

Learn About Case Management

Substance Use Disorder

In addition to plan coverage for treatment of mental health and/or substance issues, we also have online tools (in partnership with New York State) that will help determine risk levels and the appropriate level of care for at-risk individuals.

Substance Use Disorder Treatment

Behavioral Health Quality

The Behavioral Health Quality and Compliance Program develops, implements, and monitors quality improvement activities.

Education Tools HEDIS Measures®  

Additional Behavioral Health Resources

  1. OMH Mental Health Program Directory: https://my.omh.ny.gov/bi/pd
  2. National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  3. New York State Domestic Violence Hotline: 1-800-942-6906
  4. Crisis Text Line: Text “Got5” to 741-741

Child and Adolescent Psychiatry Phone Consultation Service

“Consultations with Child and Adolescent Psychiatrists”
“Completely free for all prescribers in New York State who treat children and youth”
“Mission - To strengthen and support the ability of New York’s pediatric primary care providers (PCPs) to deliver care to children and families who experience mild-to-moderate mental health concerns.” Call (855)-227-7272