- The Laurels of Hamilton (Hamilton, OH)
- …to lia censed nurse; provide skin care as needed.Meet guests' mental health and social service needs.QualificationsHigh school graduate/GEDSTNA certification ... up and bed time. Ask about the options!The Laurel Health Care Company offers one of the leading employee...PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management… more
- Kepro (Minneapolis, MN)
- …health solutions in the public sector. Acentra is looking for a Utilization Management - Mental Health Clinical Reviewer to join our growing team. ... upon job offer. + Minimum five years direct clinical work as a mental health professional in a variety of clinical settings + Knowledge of the organization… more
- Magellan Health Services (Chalfont, PA)
- …time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources ... Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes … more
- Magellan Health Services (Johnstown, PA)
- …time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources ... collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient… more
- CVS Health (Phoenix, AZ)
- …of the utilization /benefit management program for preauthorization for mental health services. Applies critical thinking and is knowledgeable in ... behavioral health + 3+ years knowledge of mental health and substance abuse disorders +...Direct clinical experience in a hospital setting or prior Utilization Management experience. **Education** + If RN,… more
- Centene Corporation (Tallahassee, FL)
- …appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization review ... performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH...LCSW- License Clinical Social Worker required or + LMHC-Licensed Mental Health Counselor required or + LPC-Licensed… more
- SSM Health (St. Louis, MO)
- …the department leaders and staff in managing fiscal resources for the utilization management program. Maintains and leverages ongoing business relationships with ... with surveying and accreditation bodies as the expert on utilization management (UM) policies and practices. +...existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care… 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 ... You'll Be Doing:** + Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director, Utilization Management is responsible for directing, leading, and ... the business processes and operations for all levels of utilization management review (ie, Precertification and Intake...collaboration and coordination with enterprise or divisional based behavioral health and / or case management leaders… more
- Centene Corporation (Jefferson City, MO)
- …who reside in either CST or EST time zone with experience in mental health settings and utilization management / review. **Position Purpose:** Performs a ... health and substance abuse preferred. Knowledge of mental health and substance abuse utilization...Licensure required Additional Details: * Department: IL Meridian Behavioral Health Utilization Management Pay Range:… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... to justify acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for concurrent review… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Commonwealth Care Alliance (Boston, MA)
- … management experience required + 3+ years experience working in a health plan, specifically with utilization management required + 3+ years ... and facilities under the provisions of CCA's benefits plan.The Manager, Utilization Management is responsible for overseeing and managing the… more
- Fallon Health (Worcester, MA)
- …MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management ; network management ; medical policy and ... **Overview** **About us:** Fallon Health is a company that cares. We prioritize...age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical ... and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
- LifePoint Health (Athens, TN)
- …Minimum Work ExperienceMinimum 1 year experience in Inpatient Psychiatric Facility Utilization Management and/or intake/admissions in a psychiatric setting:X ... seeking talent to fill the position of Intake Nurse and Utilization Specialist for ourGeroPsychDepartment.This job is permanent,full-time. Core competencies include,… more
- Independent Health (Buffalo, NY)
- …and Accountable. **Essential Accountabilities** + Provide high quality, professional utilization management services: (medical necessity review for Prior ... and concurrent review.) + Prompt, courteous, and error free in performing utilization management functions. + Available to answer inbound phone calls… more
- HCA Healthcare (Nashville, TN)
- …or behavioral health experience required** + **1-3 years relevant case management / utilization review experience preferred** + **Must hold and maintain ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Nurse BH WFH you want with your...which he or she resides and practices as a mental health professional in accordance with law… more
- FLACRA (Clifton Springs, NY)
- …of work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by email. ... PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area...effective communications strategies among peers, medical staff, addiction and mental health providers and other community agencies… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
