- Health Care Service Corporation (Albuquerque, NM)
- …Autism Spectrum Diagnoses (ASD). **JOB REQUIREMENTS:** **Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, BCBA, ... This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical necessity… more
- Centene Corporation (Harrisburg, PA)
- …POSITION IS REMOTE/WORK FROM HOME SUPPORTING PENNSYLVANIA HEALTH & WELLNESS BEHAVIORAL HEALTH UTILIZATION MANAGEMENT.** **APPLICANTS MUST EITHER HOLD AN ... PA LICENSURE; RN'S MUST HAVE A COMPACT LICENSURE AND BEHAVIORAL HEALTH EXPERIENCE. NEED TO BE ABLE...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- CVS Health (Indianapolis, IN)
- …experience working with clients with an Autism Diagnosis + Valid unrestricted independent professional behavioral health clinical license to practice per ... due to region of members.** **As a UM Clinician Behavioral Health you will:** + Utilize clinical...to promote quality effectiveness of healthcare services and benefit utilization . + Consult and lend expertise to other internal… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... request clarification. The BH UM Reviewer will use his/her professional judgment to evaluate the request to ensure that...in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder… 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 ... monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with initial assessments, as… more
- MVP Health Care (Rochester, NY)
- …, and an **Inclusive Workplace** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and ... continuous improvement. To achieve this, we're looking for a ** Professional , Behavioral Health ** to join...with at least 2 years being ASD related + Utilization or Case Management experience in a managed care… more
- UnityPoint Health (Cedar Rapids, IA)
- …site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional… more
- CVS Health (Austin, TX)
- …applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review experience ... At CVS Health , we're building a world of health...Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation… more
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
- LifeCenter Northwest (Bellevue, WA)
- …Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that ... and executes strategies to improve organ allocation strategy and organ utilization , collaborates closely with transplant programs and the surgical recovery team… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …years of the General Experience must have been working with persons with behavioral health disabilities or an intellectual disability. DEPARTMENT OF VETERANS ... Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251119-5613FP-001 Location Middletown, CT Date Opened 12/11/2025 12:00:00 AM Salary… more
- Tenet Healthcare (Detroit, MI)
- …: Minimum Qualifications BSN preferred. At least two (2) years acute hospital or Behavioral Health patient care experience required. One (1) year hospital acute ... we provide a comprehensive benefit package that prioritizes your health , professional development, and work-life balance. The...or behavioral health case management experience preferred. Active… more
- LifeCenter Northwest (Bellevue, WA)
- …Position Type Full Time Description and Qualifications The Manager, Organ Utilization (OUM) provides strategic leadership and operational oversight for the Organ ... Utilization Coordinator Team (OUCT), directing key aspects of abdominal...mentor team members through constructive feedback, skill development, and professional growth opportunities. + Conduct regular performance evaluations, set… more
- Centene Corporation (Harrisburg, PA)
- …EASTERN TIME ZONE/CENTRAL TIME ZONE.** **IDEAL APPLICANTS WILL HAVE CHILDREN/ADOLECENT BEHAVIORAL HEALTH EXPERIENCE AND HOLD A PENNSYLVANIA LICENSURE.** ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + Board… more
- Veterans Affairs, Veterans Health Administration (Loveland, CO)
- …in the Mental Health Service Line (MHSL) works in the Behavioral Health Interdisciplinary Program (BHIP)/Chronic Care Model (CCM). They independently handle ... full, current, and unrestricted license to independently practice as a Licensed Professional Mental Health Counselor, which includes diagnosis and treatment.… more
- State of Indiana (Indianapolis, IN)
- …+ Referral Bonus program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for the Public Service Loan ... through access to high quality care and services. You serve as the utilization management subject-matter expert in health care delivery, develops utilization… more
- Elevance Health (Tampa, FL)
- …is responsible for managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care ... management and/or concurrent review to ensure cost effective utilization of health , mental health ,...our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
- Elevance Health (Indianapolis, IN)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... ** Utilization Management Medical Director - Indiana Medicaid** **Location:**...IN Medicaid members. Responsible for the administration of physical health medical services, to ensure the appropriate and most… more
- AmeriHealth Caritas (Washington, DC)
- …Medical Director for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring they meet the ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
- Centene Corporation (Phoenix, AZ)
- …to ensure level of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards ... everything for our 28 million members as a clinical professional on our Medical Management/ Health Services team....licensure as outlined by the applicable state (BCBA) required. Behavioral health clinical knowledge and ability to… more
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