• Utilization Review Registered Nurse-…

    Pipeline Health System, LLC (Toast, NC)
    Job Title: Utilization Review Registered Nurse- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) ... position supports the Mission of Pipeline Health through the provision of distinctive and compassionate care...care to our patients. This position is responsible for utilization review , assessment of discharge planning needs… more
    Pipeline Health System, LLC (10/26/24)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review more
    Centene Corporation (11/06/24)
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  • Associate Nurse Mgr / UR Review RN…

    Premier Health (Troy, OH)
    Position: ASSOCIATE NURSE MGR/ UTILIZATION REVIEW RN Dept: Inpatient Behavioral Health Shift: Full time 72 hours/pp: 7am-7:30pm Facility: Upper Valley ... A COMBINATION POSITION: 24 HOURS/PP ASSOCIATE NURSE MANAGER AND 48 HOURS/PP UTILIZATION REVIEW RN._** The **Associate Nurse Manager (ANM)-Inpatient Unit** serves… more
    Premier Health (11/07/24)
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  • Integrated Care Coordinator (SCRBH) - Youth…

    Spokane County (Spokane, WA)
    … Administrative Service Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review Integrated Care. ... Bureau. + Performs other related duties as required/assigned. Behavioral Health Administrative Services Organization Utilization Review Integrated Care… more
    Spokane County (10/13/24)
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  • Utilization Review Social Work Care…

    Hartford HealthCare (Torrington, CT)
    …milieu. * Master's degree in Social Work * Active LCSW required * Two years with behavioral health utilization review As a Hartford HealthCare entity, ... of the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP… more
    Hartford HealthCare (11/06/24)
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  • Utilization Management Clinical Consultant

    CVS Health (Trenton, NJ)
    …the utilization /benefit management function **Required Qualifications** + Licensed Independent Behavioral Health clinician or a Registered Nurse (RN) with ... holiday schedules **Preferred** **Qualifications** + Managed care/ utilization review experience + Experience in a behavioral ... review experience + Experience in a behavioral health inpatient and outpatient setting +… more
    CVS Health (11/07/24)
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  • Coord- Behavioral Health Ult Mg

    BronxCare Health System (Bronx, NY)
    Health Qualifications Minimum of three (3) years experience specifically in Behavioral Health Utilization review and casemanagement.Managed Care or ... Overview The Coordinator- Behavioral Health Utilization Management (BH-UMC) will review and monitor all patientsadmitted into psychiatry or substance… more
    BronxCare Health System (09/18/24)
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  • Manager II Behavioral Health

    Elevance Health (FL)
    … Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM). Serves as a ... cost of care initiatives. + May attend meetings to review UM and discusses facility issues. + Hires, trains,...UM: MS in social work, counseling, psychology or related behavioral health field or a degree in… more
    Elevance Health (11/02/24)
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  • Utilization Management Clinical Consultant…

    CVS Health (Phoenix, AZ)
    …working in the Arizona Medicaid Health system + Managed care experience + Utilization review experience + Prior authorization experience + Claims review ... in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and ABA. Utilizes clinical experience and skills… more
    CVS Health (11/08/24)
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  • Utilization Management Clinical Consultant…

    CVS Health (Charleston, WV)
    … care more personal, convenient and affordable. This is a fully **remote** Utilization Review Clinical Consultant with a schedule of Monday-Friday, 8am -5pm ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
    CVS Health (11/07/24)
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  • Utilization Management Reviewer…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …license: Registered Nurse, LICSW, LMHC + 3-5 years of clinical experience in Behavioral Health Care settings + Utilization Management experience preferred ... highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • Utilization Reviewer - Behavioral

    El Paso County (Colorado Springs, CO)
    Utilization Reviewer - Behavioral Health Print (https://www.governmentjobs.com/careers/elpasocountyco/jobs/newprint/4719458) Apply  Utilization Reviewer ... and individuals with intellectual and developmental disabilities (IDD). Examines cases from a behavioral health perspective and provides behavioral health more
    El Paso County (11/08/24)
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  • Behavioral Health Clinician…

    Molina Healthcare (Bowling Green, KY)
    …we are seeking a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG ... and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
    Molina Healthcare (10/12/24)
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  • Utilization Review Coord

    Covenant Health Inc. (Louisville, TN)
    Overview Utilization Review Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest ... committee(s). + Performs Quality Improvement functions within the Peninsula Behavioral Health system. + Attends workshops, seminars,...or retrospective utilization data. + Monitors current utilization review criteria and length of stay… more
    Covenant Health Inc. (11/05/24)
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  • UM Coordinator - Utilization Review

    Hackensack Meridian Health (Belle Mead, NJ)
    …The Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral health resource management to review and coordinate ... a case by case basis. Applies case management and utilization review principles in monitoring the delivery...+ 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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  • Utilization Review Specialist

    Sutter Health (Berkeley, CA)
    …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with...in lieu of the required degree or diploma_ Department, Behavioral Health : Master's in Social Work or… more
    Sutter Health (10/24/24)
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  • Utilization Review Nurse Coordinator…

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
    State of Connecticut, Department of Administrative Services (11/07/24)
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  • RN - Utilization Review Case Manager

    LifePoint Health (Danville, VA)
    *Registered Nurse, RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must have ... Utilization Review experience.** ** * ** *Your...network committed to/making communities healthier/(R)with acute care, rehabilitation, and behavioral health facilities from coast to coast.… more
    LifePoint Health (09/10/24)
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  • Utilization Review Nurse (40 Hour)

    State of Connecticut, Department of Administrative Services (Middletown, CT)
    Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 241023-5612FP-001 Location Middletown, CT Date Opened 11/5/2024 12:00:00 AM Salary $78,480 - ... Families (DCF (https://portal.ct.gov/dcf) ), seeks qualified individuals for a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) position. Are you… more
    State of Connecticut, Department of Administrative Services (11/05/24)
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  • Utilization Review Clinician- ABA

    Centene Corporation (Tallahassee, FL)
    …degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with… more
    Centene Corporation (09/19/24)
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