- Molina Healthcare (Louisville, KY)
- …be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and ... JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
- Centene Corporation (Phoenix, AZ)
- …review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers ... education to members and their families regrading ABA and BH utilization process + Provides feedback to...and healthcare teams to review care services related to Applied Behavior Analysis Services… more
- Centene Corporation (Tallahassee, FL)
- …review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers ... education to members and their families regrading ABA and BH utilization process + Provides feedback to...and healthcare teams to review care services related to Applied Behavior Analysis Services… more
- Centene Corporation (Austin, TX)
- … of services + Provides education to providers members and their families regrading BH utilization process + Interacts with BH healthcare providers as ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- CVS Health (Harrisburg, PA)
- …hospital setting required for either BH or RN -1+ years of utilization review / utilization management required (ie concurrent review , ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- AmeriHealth Caritas (LA)
- …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer's discretion to retain ... Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity… more
- MVP Health Care (Schenectady, NY)
- …. The Behavioral Health ( BH ) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This ... you'll bring:** + Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse...with at least 2 years being ASD related + Utilization or Case Management experience in a managed care… more
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