- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating ... strong, collaborative relationships with behavioral health providers and driving performance improvement...teams to support consistency and quality across BH and Health Home providers. - Participate in case review… more
- Battelle Memorial Institute (Columbus, OH)
- …working in a dynamic, mission-driven environment. This position supports outpatient behavioral health activities by conducting intake interviews, assisting with ... + Assist with the management and treatment of outpatient behavioral health activities + Under the supervision...program policy + Coordinate attendance and agenda at Case Review Committee with military and civilian agencies + Coordinate… more
- Battelle Memorial Institute (Sneads Ferry, NC)
- …environment. The Licensed Clinical Social Worker position serves as a behavioral health care provider within operational units, delivering evidence-based ... **Responsibilities** + Function within an operational unit as a Behavioral Health Care Provider + Attend and...the electronic medical records of all patients contacted for review by the managing physician + Routinely staff difficult… more
- Commonwealth Care Alliance (Boston, MA)
- …utilization management systems and workflows for populations with complex medical, behavioral health , and/or social needs. + Strong understanding of ... success. + Conduct regular provider meetings (virtual and in-person) to review performance, discuss program updates, and address operational challenges. + Represent… more
- Battelle Memorial Institute (Tacoma, WA)
- …and experiences and welcome all qualified individuals to apply. **Job Summary** The Health Research and Analytics (HRA) business line is seeking a highly motivated, ... SOF personnel to develop and apply advanced cognitive, mental, and behavioral skills for optimal performance in training and operational environments, utilizing… more
- Monte Nido (Waltham, MA)
- …regulatory agencies. + Conduct psychosocial assessments, participate in treatment planning, utilization review , and discharge planning. + Conduct individual, ... people to realize their healthy selves. **Family Therapist** **Walden Behavioral Care** **Waltham, MA** Walden Behavioral Care...Assistance Program (EAP) + Flexible Spending Account (FSA) + Health Savings Account (HSA) + Paid time off +… more
- Battelle Memorial Institute (San Diego, CA)
- …and experiences and welcome all qualified individuals to apply. **Job Summary** The Health Research and Analytics (HRA) business line is seeking a highly motivated, ... This position plays a key role in supporting the psychological health and operational readiness of military personnel. The Neuropsychologist provides expert… more
- Monte Nido (White Plains, NY)
- …Qualifications: + At least 5 years of leadership experience in a behavioral health setting is preferred; may substitute leadership experience elsewhere. ... + Working knowledge of admissions and intake, Utilization Review , and 3rd party or insurance...Experience in an Eating Disorder program or other residential behavioral health setting is very helpful. +… more
- Monte Nido (Clifton, VA)
- …Qualifications: + At least 5 years of leadership experience in a behavioral health setting is preferred; may substitute leadership experience elsewhere. ... + Working knowledge of admissions and intake, Utilization Review , and 3rd party or insurance...Experience in an Eating Disorder program or other residential behavioral health setting is very helpful. +… more
- Katmai (Usaf Academy, CO)
- …levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. Adhere to ... specialized tests, and surgery. + Formulate nursing diagnosis based upon health status data by accurately interpreting assessment data and identifying patient… more
- National Renewable Energy Laboratory (Golden, CO)
- …in this position is contingent upon successful completion of: + Medical evaluation and behavioral health screening, as required by 10 CFR Part 1046. + A ... Emergency Notification System (ENS) sheets and SOPs. Surveillance & Technology Utilization : + Operate CCTV systems for situational awareness and incident response… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion...in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder… more
- UNC Health Care (Hendersonville, NC)
- …for behavioral health services. Working closely with behavioral health clinicians, utilization review , case management, and finance teams, the ... This role involves the review , coordination, and tracking of behavioral health referrals, ensures adherence to safety protocols, age-appropriate clinical… more
- Spectrum Billing Solutions (Skokie, IL)
- …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- Health Care Service Corporation (Albuquerque, NM)
- …**Job Summary** This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) ... reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity… more
- Centene Corporation (Austin, TX)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- MVP Health Care (Schenectady, NY)
- …For in New York** , and an **Inclusive Workplace** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental ... with at least 2 years being ASD related + Utilization or Case Management experience in a managed care...our customers in every interaction **Your key responsibilities:** + Review all requests for behavioral health… more
- CVS Health (Harrisburg, PA)
- …clinically appropriate treatment, evidence based care an clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. - ... One of the following is required: Unencumbered Master's Level Behavioral Health clinical license in the state...required for either BH or RN -1+ years of utilization review / utilization management required (ie… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …a member's benefit coverage while working remotely. Primary Responsibilities * Performs behavioral health clinical utilization reviews using evidenced based ... pace and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW...diagnostics. + Preferred: Third party reimbursement knowledge. + Preferred: Utilization Review experience, someone who can talk… more
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