• Utilization Management Behavioral

    Humana (Columbus, OH)
    … first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
    Humana (11/13/24)
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  • Utilization Review Specialist,…

    Sutter Health (Berkeley, CA)
    …from accidental, intentional, or inappropriate disclosure. **DEPARTMENT REQUIRED EDUCATION** Department, Behavioral Health : Master's in Social Work or related ... review activities and processes. Collaborate with medical, nursing and other professional personnel to help interpret utilization review program changes and… more
    Sutter Health (10/24/24)
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  • Utilization Management Reviewer…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    … medical necessity criteria, interrater reliability test What You Bring : + Behavioral Health professional with an active Massachusetts license: Registered ... case management and disease state management intervention + Maintain professional licensure and seeks out continuous learning opportunities to...LICSW, LMHC + 3-5 years of clinical experience in Behavioral Health Care settings + Utilization more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …workplace flexibility. **THIS POSITION IS REMOTE/WORK FROM HOME SUPPORTING ILLINOIS MEDICAID BEHAVIORAL HEALTH . WILL WORK CENTRAL TIME ZONE HOURS.** **WORK ... regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
    Centene Corporation (11/16/24)
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  • Manager II Behavioral Health

    Elevance Health (Seven Fields, PA)
    …locations. The **Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Manager II Behavioral Health Services** **Location:** This position...LMFT, LMSW or Clinical Psychologist to practice as a health professional within the scope of licensure… more
    Elevance Health (11/15/24)
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  • Integrated Care Coordinator (SCRBH) - Youth…

    Spokane County (Spokane, WA)
    …providing behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health services for eligible ... Health Administrative Service Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review Integrated… more
    Spokane County (10/13/24)
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  • Director, Behavioral Health

    VNS Health (Manhattan, NY)
    …+ Participates in the development and implementation of the behavioral health sections of the Quality Management (QM)/ Utilization Management (UM) Plan. ... monitors and evaluates Utilization and Care Management metrics specific to Behavioral health services across all plan types as necessary. This process… more
    VNS Health (09/04/24)
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  • UM Coordinator - Utilization Review - F/T…

    Hackensack Meridian Health (Belle Mead, NJ)
    Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral health resource management to review and coordinate the care ... ACCESS center staff and PFS department to ensure appropriate utilization of resources and benefits on a case by...+ Minimum five years of clinical experience in a behavioral health care setting. + Excellent written… more
    Hackensack Meridian Health (10/28/24)
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  • Care Manager (SUD utilization review…

    Magellan Health Services (Boise, ID)
    …LCSW, LSW, LPC or RN. Minimum 2 years experience post degree in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong ... other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse...treatment needs are met. Interacts with providers in a professional , respectful manner that facilitates the treatment process. Other… more
    Magellan Health Services (11/12/24)
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  • Director, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …the CMO and VPMA to develop and advance the UM program, collaborates with the Behavioral Health UM team the multiple clinical groups and provider partners in ... of Utilization Management leads and manages all utilization management (UM) functions for physical health ...five (5) years of clinical experience in medical or behavioral health care delivery **Required Knowledge, Skills… more
    Commonwealth Care Alliance (09/19/24)
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  • Utilization Review Nurse Coordinator (40…

    State of Connecticut, Department of Administrative Services (East Hartford, 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...Offering Job Growth, Competitive Benefits, and Flexible Schedule; + Professional growth and paid professional development opportunities.… more
    State of Connecticut, Department of Administrative Services (11/07/24)
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  • RN - Utilization Review Case Manager

    LifePoint Health (Danville, VA)
    …delivery network committed to/making communities healthier/(R)with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your ... *Registered Nurse, RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000...Comprehensive medical, dental, and vision plans, plus flexible-spending and health - savings accounts . Competitive paid time off and… more
    LifePoint Health (09/10/24)
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  • Behavioral Health Care Manager II…

    Elevance Health (FL)
    …initiatives. **Minimum Requirements:** + Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 ... candidate must live within 50 miles of an Elevance Health PulsePoint office. This utilization management role...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure… more
    Elevance Health (11/09/24)
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  • Professional Community Liaison - Dunn…

    UT Health (Houston, TX)
    Professional Community Liaison - Dunn Behavioral Sciences Center/HCPC at UTHealth Houston **Location:** Houston, Texas **Hot** **Category:** Professional ... + Free financial and legal counseling + Free mental health counseling services + Gym membership discounts and access...of the area. **Position Summary:** Responsible for increasing the utilization of the Behavioral Sciences Campus services… more
    UT Health (10/04/24)
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  • Behavioral Health

    St. Peters Health (Helena, MT)
    The Behavioral Health Professional Licensure Candidate Per Diem (BHP) is an integral member of the primary care team who works to identify, triage and ... and crises, stress-related physical symptoms and ineffective patterns of healthcare utilization . Behavioral health services include assessment, treatment… more
    St. Peters Health (10/23/24)
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  • Clinical Case Manager, Transitions of Care,…

    CVS Health (Oklahoma City, OK)
    …coordinating all care management activities with members to evaluate the medical and behavioral health needs to facilitate the member's overall wellness. + ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
    CVS Health (10/09/24)
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  • Behavioral Health Case Manager-…

    Banner Health (Scottsdale, AZ)
    …Shift:** Day **Job Category:** Clinical Care For more than 30 years, Banner Behavioral Health Hospital has provided a nationally recognized, behavioral ... program for children, teens and adults faced with psychiatric, behavioral health , or chemical dependency challenges. We...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
    Banner Health (10/31/24)
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  • Behavioral Health Consultant- LCSW…

    Community Health Network (Indianapolis, IN)
    Behavioral Health Consultant- LCSW or LMHC Required- East Job Ref 2407202 Category Behavioral Health Job Family Behavioral Health Therapist, ... couldn't do it without you. **Make a Difference** The Behavioral Health Consultant provides direct patient/family care...required. - 2 + years of experience providing mental health treatment required. - Utilization of conventional… more
    Community Health Network (10/30/24)
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  • Organ Utilization Coordinator I

    LifeCenter Northwest (Bellevue, WA)
    Organ Utilization Coordinator I Job Details Job Location Bellevue - Bellevue, WA Position Type Full Time Salary Range $66,122.00 - $95,904.00 Salary Description and ... Qualifications The Organ Utilization Coordinator (OUC) is accountable for all activities related to the allocation and utilization of organs from donors. This… more
    LifeCenter Northwest (10/18/24)
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  • Clinical Case Manager, Behavioral

    CVS Health (Miami, FL)
    … care more personal, convenient and affordable. **Summary** : The Clinical Case Manager, Behavioral Health /SMI is a field based role with up to 40% travel ... activities with members to ensure that their medical and behavioral health needs are met and to...applications (Teams, Outlook, Word, Excel, etc.) + Licensed mental health professional with current unencumbered license in… more
    CVS Health (11/14/24)
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