- 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 ... your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care ...dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians,… more
- Spokane County (Spokane, WA)
- …Health Administrative Service Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review ... Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator: + Performs...management, utilization review, or concurrent review of behavioral health inpatient and outpatient care… more
- CVS Health (Columbus, OH)
- …+ Experience in a behavioral health inpatient setting + Managed care experience + Utilization review experience + Ability to multitask, prioritize and ... treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. Utilizes… more
- BronxCare Health System (Bronx, NY)
- …Qualifications Minimum of three (3) years experience specifically in Behavioral Health Utilization review and casemanagement.Managed Care or Discharge ... Overview The Coordinator- Behavioral Health Utilization Management...identifying delays/barriers to discharge. Knowledge of Medicare, Medicaid, Managed Care and OASIS guidelines, medicalnecessity criteria pertaining to psychiatry… more
- Elevance Health (FL)
- … Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM). Serves as a ... required. Additional requirements for BH UM: MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5… more
- CVS Health (Charleston, WV)
- …appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. + ... or certification + 3+ years clinical practice experience in behavioral health , eg, hospital setting, residential setting, alternative care setting, or… more
- CVS Health (Phoenix, AZ)
- …appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and ABA. Utilizes clinical experience and skills in ... **Required Qualifications** + Active and unrestricted RN license or behavioral health license in the state of...the Arizona Medicaid Health system + Managed care experience + Utilization review experience +… more
- Molina Healthcare (Omaha, NE)
- …with previous experience in BEHAVIORAL HEALTH , Hospital Acute Care , Concurrent Review/_** **_Utilization Review / Utilization Management and knowledge of ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , for members with high need… more
- Sutter Health (Berkeley, CA)
- …from accidental, intentional, or inappropriate disclosure. **DEPARTMENT REQUIRED EDUCATION** Department, Behavioral Health : Master's in Social Work or related ... Collaborate with case managers, clinical nursing staff and others to ensure appropriate utilization and quality care through utilization review, tracking and… more
- El Paso County (Colorado Springs, CO)
- Utilization Reviewer - Behavioral Health ...with experts at State departments including Health Care Policy and Financing, Office of Behavioral ... Print (https://www.governmentjobs.com/careers/elpasocountyco/jobs/newprint/4719458) Apply Utilization Reviewer - Behavioral Health Salary $71,420.00 - $107,180.00 Annually… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional... care experience in an acute or outpatient behavioral health setting + Experience with … more
- CVS Health (Carson City, NV)
- …appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus within a ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....Qualifications** + 3+ years of post RN experience in behavioral health + 3+ years knowledge of… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) position ... to our patients. This position is responsible for utilization review, assessment of discharge planning needs and coordination...with the team members who are recognized leaders within health care . Education: + Bachelor's degree in… more
- Centene Corporation (Lincoln, NE)
- …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
- 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 ... Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge... Health field **Required Experience** 3+ years Behavioral Health hospital acute care /medical… more
- Stanford Health Care (Palo Alto, CA)
- …preventive care , telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices. ... of America) Why work at Stanford Medicine | Stanford Health Care (SHC)? Here is your opportunity...assistance! **This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization … more
- Commonwealth Care Alliance (Boston, MA)
- …improvement. + Minimum five (5) years of clinical experience in medical or behavioral health care delivery **Required Knowledge, Skills & Abilities:** ... develop and advance the UM program, collaborates with the Behavioral Health UM team the multiple clinical...to utilization management + Demonstrated knowledge of health care industry trends, developments and issues.… more
- Covenant Health Inc. (Louisville, TN)
- …appropriate committee(s). + Performs Quality Improvement functions within the Peninsula Behavioral Health system. + Attends workshops, seminars, and in-services ... and evaluation of program policies and criteria within Peninsula Behavioral Health . + Assists in the formulation... Health . + Assists in the formulation of health service utilization and cost forecasts with… more
- CVS Health (Oklahoma City, OK)
- …channels. + Ability to speak to medical and behavioral health professionals to influence appropriate member care . + Utilizes influencing/motivational ... care or outpatient clinic/facility) + Must complete the Behavioral Health Case Manager certification training provided...+ 1+ year(s) of crisis intervention experience + Managed care / utilization review experience + Case management and… more
- CVS Health (Trenton, NJ)
- …appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. + ... the utilization /benefit management function **Required Qualifications** + Licensed Independent Behavioral Health clinician or a Registered Nurse (RN) with… more