- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR ... monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates… more
- Centene Corporation (Austin, TX)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... or Texas.** **Hours are 9:30am-6pm PST.** **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. Monitors… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans preferred. + Knowledge of ABA services and BH utilization review process preferred. + Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
- Molina Healthcare (North Syracuse, NY)
- …site of service. **We are seeking a candidate with a LPN licensure, UM and Inpatient Review experience. The Care Review Clinician must be able to work ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- City of Durham (Durham, NC)
- …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. + Ability ... with service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management? + No… more
- Molina Healthcare (Columbus, OH)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE**… more
- Molina Healthcare (San Jose, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Managed Care Utilization Management and knowledge ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **RN MULTI STATE / COMPACT… more
- Elevance Health (Costa Mesa, CA)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... **Be Part of an Extraordinary Team** **Medical Management Clinician Senior** **Location: Remote-** Candidates must reside within 50 miles or 1-hour commute each way… more
- Molina Healthcare (Kenosha, WI)
- …seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization Review / Utilization Management and ... knowledge of Interqual / MCG guidelines. WI or COMPACT RN LICENSURE IS REQUIRED within 30 days of employment._** **_Ability/knowledge to cross train, inpatient medical to inpatient BH or inpatient Medical to PA is preferred._** **_Excellent computer skills and… more
- Hartford HealthCare (Dayville, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... throughout Eastern Connecticut. _**_ _*Job Summary*_ Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare,… more
- Hartford HealthCare (Groton, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and then to the student's home. *_Job Summary_* Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare, and deliver… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
- Hartford HealthCare (Mansfield Center, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... absence of Program Manager. Key responsibilities of Lead Behavioral Health Clinician : * Conducts a comprehensive bio-psychosocial assessment and establishes a care… more
- Hartford HealthCare (Norwalk, CT)
- …Licensed Clinician provides individual, group, couples, and family therapy. Utilization of evidenced based practices are supported. Clinicians are encouraged to ... clinicians through clinical supervision, weekly clinical team meetings to review cases and interact with colleagues, professional development opportunities,… more
- Texas A&M University System (Bryan, TX)
- Job Title TCHATT Clinician II/MS II Agency Texas A&M University Health Science Center Department Psychiatry and Behavioral Science Proposed Minimum Salary ... Staff Job Description Glimpse of the Job The TCHATT Clinician II/MS II delivers direct clinical services and acts...assists with program evaluation activities to track and analyze utilization and effectiveness of services. What you need to… more
- Molina Healthcare (Starkville, MS)
- …Molina Care Model * Adhere to UM policies and procedures * Mentor New Care Review Clinicians during orientation period *Sign off on core competencies for new Care ... Review Clinicians during peer mentoring phase *Model New programs,...Social Worker LCSW, Licensed Marriage and Family Therapist LMFT, Utilization Management Certification (CPHM), Rehabilitation Therapy License (Occupational Therapist,… more
- Centene Corporation (Jefferson City, MO)
- …applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA ... of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - Licensed Practical… more
- Centene Corporation (Sacramento, CA)
- …applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA ... of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + For Health Net of… more
- Elevance Health (Tampa, FL)
- …or equivalent. + Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... of Florida. + Minimum of 2 years of Long-Term Care clinical or Long-Term Care utilization review experience and/or minimum of 3 years of managed care experience… more