• Manager II Behavioral Health

    Elevance Health (FL)
    … Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM). Serves as a ... appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination,...UM: MS in social work, counseling, psychology or related behavioral health field or a degree in… more
    Elevance Health (11/02/24)
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  • Utilization Management - Behavioral

    Humana (Baton Rouge, LA)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
    Humana (11/01/24)
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  • Utilization Management Reviewer…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …license: Registered Nurse, LICSW, LMHC + 3-5 years of clinical experience in Behavioral Health Care settings + Utilization Management experience preferred ... highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • Utilization Reviewer - Behavioral

    El Paso County (Colorado Springs, CO)
    Utilization Reviewer - Behavioral Health Print (https://www.governmentjobs.com/careers/elpasocountyco/jobs/newprint/4719458) Apply  Utilization Reviewer ... and individuals with intellectual and developmental disabilities (IDD). Examines cases from a behavioral health perspective and provides behavioral health more
    El Paso County (11/08/24)
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  • Behavioral Health Clinician…

    Molina Healthcare (Bowling Green, KY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge...Education** Master's Degree in Social Work, Psychology, or other Behavioral Health field **Required Experience** 3+ years… more
    Molina Healthcare (10/12/24)
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  • Coord- Behavioral Health Ult Mg

    BronxCare Health System (Bronx, NY)
    Overview The Coordinator- Behavioral Health Utilization Management (BH-UMC) will review and monitor all patientsadmitted into psychiatry or substance abuse ... appropriateness of admission according to nationally recognizedcriteria. Responsibilities The Coordinator- Behavioral Health Utilization Management (BH-UMC)… more
    BronxCare Health System (09/18/24)
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  • Clinical Reviewer - Behavioral

    Kepro (AR)
    …behavior. + 2+ years of experience in a behavioral health setting, conducting behavioral health utilization reviews or behavioral health case ... the Clinical Director and Team Supervisor, monitors provider trends, reviews government-funded behavioral health program utilization activities, and makes… more
    Kepro (10/21/24)
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  • Utilization Review Social Work Care Manager…

    Hartford HealthCare (Torrington, CT)
    …* Master's degree in Social Work * Active LCSW required * Two years with behavioral health utilization review As a Hartford HealthCare entity, Charlotte ... for care; and follow up on insurance denials. Requires in-depth knowledge of behavioral health services in order to accurately articulate and advocate for… more
    Hartford HealthCare (11/06/24)
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  • Manager II Behavioral Health

    Elevance Health (Cerritos, CA)
    The **Manager II Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case ... + MS in social work, counseling, psychology or related behavioral health field or a degree in...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum of 2… more
    Elevance Health (10/09/24)
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  • Integrated Care Coordinator (SCRBH) - Youth…

    Spokane County (Spokane, WA)
    …providing behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health services for eligible ... Health Administrative Service Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review Integrated… more
    Spokane County (10/13/24)
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  • Behavioral Health Clinical Quality…

    Elevance Health (Seven Fields, PA)
    …or related field and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed ... studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article,… more
    Elevance Health (10/04/24)
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  • Behavioral Health Professional…

    St. Peters Health (Helena, MT)
    …and crises, stress-related physical symptoms and ineffective patterns of healthcare utilization . Behavioral health services include assessment, treatment ... The Behavioral Health Professional Licensure Candidate Per Diem (BHP) is an integral member of the primary care team who works to identify, triage and support… more
    St. Peters Health (10/23/24)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
    Centene Corporation (11/06/24)
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  • Utilization Management Specialist

    FLACRA (Clifton Springs, NY)
    …(QHP) preferred. + At least one year of experience in the behavioral health field, with knowledge of utilization management practices. + Valid NYS Driver's ... Utilization Management Specialist Finger Lakes Addiction Counseling and...Recovery Agency (FLACRA) is a growing, not-for-profit provider of behavioral health and substance use treatment services… more
    FLACRA (10/25/24)
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  • Manager Clinical Behavioral Health

    Corewell Health (Grand Rapids, MI)
    …Functions + Provides operational management over the Behavioral Health Outpatient Prior Authorization program, Utilization Management, Outpatient Case ... Summary The Clinical Manager provides clinical and operational management over all behavioral health programming and services delivered to the organization's… more
    Corewell Health (10/30/24)
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  • Behavioral Health Consultant

    Adelante (Peoria, AZ)
    health issues and providers education to assist with enhancing primary care utilization of behavioral health interventions + Promote a smooth interface ... Behavioral Health Consultant Job Details Job...+ Demonstrate an understanding of facility organizational structure by utilization of appropriate channels of communication. Maintain consistent, timely… more
    Adelante (10/29/24)
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  • Utilization Management Clinical Consultant

    CVS Health (Columbus, OH)
    …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... reside in the state of Ohio + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or...health inpatient setting + Managed care experience + Utilization review experience + Ability to multitask, prioritize and… more
    CVS Health (11/06/24)
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  • ABA Prior Authorization / UR Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …Strong computer skills (Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist ​#UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
    Spectrum Billing Solutions (10/10/24)
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  • Behavioral Health Clinician (LCSW,…

    Hartford HealthCare (Farmington, CT)
    …medical providers, brief and evidence-based treatments for behavioral and mental health issues, 2. Effective utilization of screening measures and assessment ... pleased to announce a position opening for a part-time (32 hours/week) behavioral health clinician (LCSW, PhD or PsyD) in Hartford HealthCare's Tallwood Men's … more
    Hartford HealthCare (10/16/24)
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  • Utilization Management Clinical Consultant…

    CVS Health (Phoenix, AZ)
    …in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and ABA. Utilizes clinical experience and skills ... **Required Qualifications** + Active and unrestricted RN license or behavioral health license in the state of...to obtain + Experience working in the Arizona Medicaid Health system + Managed care experience + Utilization more
    CVS Health (11/08/24)
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