- Wisconsin Community Services (Milwaukee, WI)
- …Join a great team! We are a fast-paced Community Based Mental Health program seeking a person with the following qualities: Compassionate; experience working ... Attention recent graduates! Working as a Case Manager in our Targeted Case Management program offers many unique opportunities and benefits: *Our Case Managers serve… 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
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing ... products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more… 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 ... 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
- Molina Healthcare (Dayton, OH)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- CVS Health (Oklahoma City, OK)
- …+ Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to multitask, prioritize and ... every day. **_Work at home Position-Must Reside in Oklahoma_** **Position Summary: Behavioral Health Clinical Reviewer (LCSW, LCPC, RN)** Licensed clinical… more
- UnityPoint Health (Cedar Rapids, IA)
- …This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves ... a fulfilling career and make a difference with UnityPoint Health . Responsibilities Utilization Management +...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication… 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 ... About The Role BHPS provides Utilization Management services to its clients....* Experience with both inpatient and outpatient reviews for Behavioral Health (examples: TMS, ECT, ABA, Psychotherapy,… more
- Molina Healthcare (Bowling Green, KY)
- …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
- Immigration and Customs Enforcement (Washington, DC)
- …Perform other duties and responsibilities as assigned. 16. Utilization review/ management for inpatient behavioral health hospitalization for IHSC. ... Summary The Behavioral Health Case Manager is a...case coordination/ management , monitoring high risk individuals, independent behavioral health reviews, behavioral … more
- Molina Healthcare (Reno, NV)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… 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
- CVS Health (Oklahoma City, OK)
- …stakeholders to identify and address patient needs (eg care team, social work, behavioral health , utilization management , Hard-to-Reach, Central ... follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and...we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management , Care Management , Quality, and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Services Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health , Quality ... tasks under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management system, department… more
- CDPHP (Latham, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to manage multiple priorities and work independently. Experience in Behavioral Health and Utilization Management is preferred, and familiarity with ... priorities and work independently. * Experience with Behavioral Health and Utilization Management processes preferred. * Familiarity with agile… more
- Centene Corporation (Sacramento, CA)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...policies and standards. We are seeking a Licensed Clinical Behavioral Health Professional or RN to join… more
- Tenet Healthcare (Detroit, MI)
- … Health patient care experience required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN ... national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention… more
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