- CVS Health (Salt Lake City, UT)
- …care setting such as ambulatory care or outpatient clinic/facility. * Unencumbered Independent Behavioral Health clinical license in the state where they work. ... LMSW, LSW, LISW, LMFT, LMHC, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** * Knowledge of mental … more
- CVS Health (Harrisburg, PA)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health . Utilizes clinical experience and skills in a ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...+ Must have active current and unrestricted Independent clinical behavioral health license in the state of… more
- CVS Health (Jefferson City, MO)
- …standard business hours. No nights, weekends or holidays.** **As a UM Clinician Behavioral Health you will:** + Utilize clinical experience and skills in ... with clients with an Autism Diagnosis + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
- CVS Health (Austin, TX)
- …meetings when requested. - Oversight and implementation of the utilization management program for behavioral health services, including monitoring for ... and is responsible for * Leadership and counsel for utilization management * Leadership and participation in...development of clinical practice standards, policies, and procedures. - Behavioral health care management performance… more
- Elevance Health (Tampa, FL)
- … (BH CM) The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... Integrated Behavioral Health Case Management...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
- CVS Health (Baton Rouge, LA)
- …meetings when requested. * Oversight and implementation of the utilization management program for behavioral health services, including monitoring for ... in the development of clinical practice standards, policies, and procedures. * Behavioral health care management performance and coordination with… more
- Elevance Health (Olathe, KS)
- …care managers (UM).** The **Manager of Behavioral Health ** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Position specific details: We are currently hiring three Managers of Behavioral Health for our partnership with KanCare. Two will be responsible for overseeing… more
- Spokane County (Spokane, WA)
- …for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health . + Knowledge of federal ... behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health ...Coordinator: + Performs utilization management , utilization review, or concurrent review of behavioral … more
- Centene Corporation (Jefferson City, MO)
- …Licensure and/or Compact State Licensure required Additional Details: * Department: IL Meridian Behavioral Health Utilization Management Pay Range: ... CST or EST time zone with experience in mental health settings and utilization management ...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- CVS Health (Salem, OR)
- …is not accepting applicants whose only acute care experience is in behavioral health ) + Utilization Management is a 24/7 operation and work schedules ... Bring your heart to CVS Health . Every one of us at CVS ... care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and… more
- CVS Health (Tallahassee, FL)
- …working in community based mental health service like Targeted Care Management , Psychosocial Rehabilitation, or related utilization management experience ... Hours for this role are Monday-Friday 8:30a-5:00p EST. **Position Summary** The Medicare Behavioral Health Outpatient clinician will be part of the Medicare… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- Kepro (Indianapolis, IN)
- … Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical ... the public sector. Acentra is looking for a Part-Time Behavioral Health Medical Director to join our...clinical specialty if MD or DO. + Experience in Utilization Management (UM) with knowledge of Medicaid… more
- WellSense (Boston, MA)
- …matter their circumstances. **Job Summary:** The Senior Manager of Clinical Utilization Management (UM), Behavioral Health is responsible for the overall ... coordination and management of health plan UM processes, operations, and outcomes for all...will work in conjunction with the Senior Director of Behavioral Health (BH) Clinical Programs on a… more
- VNS Health (Manhattan, NY)
- …implementation of the behavioral health sections of the Quality Management (QM)/ Utilization Management (UM) Plan. Oversees the administration of all ... Develops, implements, monitors and evaluates Utilization and Care Management metrics specific to Behavioral health services across all plan types as… more
- Centene Corporation (Tallahassee, FL)
- …/ Behavioral health . 5+ years of experience in managed care, utilization management , case management , or quality improvement **For Behavioral ... liaison on utilization , quality improvement and case management activities + For NH Health Plan...possess a Florida license and experience in an outpatient behavioral health setting, experience working in provider… more
- UNC Health Care (Smithfield, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- CareFirst (Washington, DC)
- …for issues related to Medicare/Medicare Advantage, prescription drugs, utilization management , and behavioral health . **ESSENTIAL FUNCTIONS:** The ... by AHIP, the Blue Cross and Blue Shield Association (BCBSA), the Association for Behavioral Health and Wellness (ABHW), and others as needed. + In support… more
- Intermountain Health (Murray, UT)
- …innovative management of Select Health 's Health Services care management and utilization management programs. Programs include but are not ... Description:** The Healthy Connections (Care Management and Utilization Review) AVP at Select Health oversees...limited to acute, complex medical and social, behavioral health and care coordination programs across… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Dir- Utilization Management (UM) leads and shapes the UM Strategy, while providing ... for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices.… more