- Elevance Health (FL)
- … Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM). Serves as a ... Candidate will be responsible for the oversight of the utilization management team. + Responsible for a...UM: MS in social work, counseling, psychology or related behavioral health field or a degree in… more
- 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… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Registered Nurse, LICSW, LMHC + 3-5 years of clinical experience in Behavioral Health Care settings + Utilization Management experience preferred + CCM ... highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical… more
- Molina Healthcare (Bowling Green, KY)
- …we are seeking a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG ... and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- BronxCare Health System (Bronx, NY)
- Overview The Coordinator- Behavioral Health Utilization Management (BH-UMC) will review and monitor all patientsadmitted into psychiatry or substance ... for appropriateness of admission according to nationally recognizedcriteria. Responsibilities The Coordinator- Behavioral Health Utilization Management … more
- Elevance Health (Cerritos, CA)
- The **Manager II Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health ... + 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… more
- Elevance Health (Seven Fields, PA)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article,… more
- FLACRA (Clifton Springs, NY)
- …experience in the behavioral health field, with knowledge of utilization management practices. + Valid NYS Driver's License. Job Requirements: Key ... Utilization Management Specialist Finger Lakes Addiction...Recovery Agency (FLACRA) is a growing, not-for-profit provider of behavioral health and substance use treatment services… more
- Kepro (AR)
- … setting, conducting behavioral health utilization reviews or behavioral health case management . + Ability to work with HIPAA confidential ... the Clinical Director and Team Supervisor, monitors provider trends, reviews government-funded behavioral health program utilization activities, and makes… more
- Corewell Health (Grand Rapids, MI)
- …Functions + Provides operational management over the Behavioral Health Outpatient Prior Authorization program, Utilization Management , Outpatient ... Job Summary The Clinical Manager provides clinical and operational management over all behavioral health programming and services delivered to the… more
- CVS Health (Carson City, NV)
- …coordinate, document and communicate all aspects of the utilization /benefit management program for preauthorization for mental health services. Applies ... clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus… more
- CVS Health (Austin, TX)
- …standard business hours. No nights, weekends or holidays.** **As a UM Clinician Behavioral Health you will:** + Utilize clinical experience and skills in ... with clients with an Autism Diagnosis + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
- 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
- CVS Health (Trenton, NJ)
- …utilization /benefit management function **Required Qualifications** + Licensed Independent Behavioral Health clinician or a Registered Nurse (RN) with ... **Qualifications** + Managed care/ utilization review experience + Experience in a behavioral health inpatient and outpatient setting + Ability to multitask,… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the ... for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices.… more
- CVS Health (Charleston, WV)
- …clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... **Required Qualifications** + Must reside in West Virginia + Licensed independent behavioral health clinician with West Virginia state licensure (LCSW, LPCC,… more
- 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. ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...reside in the state of Ohio + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or… more
- CVS Health (Baton Rouge, LA)
- …/benefit management function. **Required** **Qualifications** + Licensed independent Behavioral Health clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to… more
- Covenant Health Inc. (Louisville, TN)
- …(5) years experience in mental health field, two (2) years experience of utilization management and knowledge of third party requirements. Must be able to ... appropriate committee(s). + Performs Quality Improvement functions within the Peninsula Behavioral Health system. + Attends workshops, seminars, and in-services… more
- Commonwealth Care Alliance (Boston, MA)
- …of Utilization Management leads and manages all utilization management (UM) functions for physical health services and long term services and ... develop and advance the UM program, collaborates with the Behavioral Health UM team the multiple clinical...+ Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health… more