- Community Health Plan of Washington (Eugene, OR)
- …equitable work environment. About the Role The Level I Utilization Management Clinician performs utilization review for medical or behavioral health ... requests using utilization review criteria, technologies, and tools. Identifies, coordinates, and implements high quality, cost-effective alternatives when… more
- Saint Francis Health System (Tulsa, OK)
- …an on-site office location (not a remote position)Will perform admit, discharge chart review and other patient care duties from an office location via secure virtual ... toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and… more
- Centene Corporation (Austin, TX)
- …insight and guidance on the review of member medical records to the utilization review BH team + Provides guidance and expert knowledge as appropriate to ... the behavioral health utilization review team members to ensure the assessment of care determination is in accordance with policies, procedures and regulations +… more
- Centene Corporation (Oklahoma City, OK)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... is a remote position **Position Purpose:** Performs a clinical review and assesses care related to mental health and...Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members… more
- Centene Corporation (Oklahoma City, OK)
- …assess ABA Treatment Plans preferred. Knowledge of ABA services and BH utilization review process preferred. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
- Centene Corporation (Phoenix, AZ)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... **must reside in the state of Arizona** **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and… more
- Centene Corporation (New York, NY)
- …may also provide education on the medical review process. + The Utilization Management clinician (LPN) makes coverage decisions based on specific criteria ... **Education/Experience:** Associate's degree preferred; Bachelors Degree preferred. 1-3 years Utilization Review experience preferred. Managed care experience… more
- Molina Healthcare (Long Beach, CA)
- **JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE** **For this position we are seeking a (RN) Registered Nurse with previous experience ... in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. CALIFORNIA LICENSURE IS… more
- Molina Healthcare (SC)
- **_JOB TITLE: CARE REVIEW CLINICIAN INPATIENT REVIEW BEHAVIORAL HEALTH : REGISTERED NURSE (2 openings)_** **_For this position we are seeking a (RN) ... Registered Nurse with previous experience in Behavioral Health Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge… more
- Kepro (Indianapolis, IN)
- …issues + A strong knowledge of Quality Assurance (QA) and Utilization Review (UR) + A contemporary clinician who understands major trends in healthcare ... Examiners in the State of Indiana, Michigan, or Illinois + Utilization Management (UM) review experience + Experience as a physician executive with significant… more
- Molina Healthcare (New York, NY)
- …for Medicaid .** **We are looking for a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization Management (UM) and ... experience are highly preferred. Additional experience with appeals, quality review , and experience with data collection/reports.** **_Bilingual candidates that… more
- City of Durham (Durham, NC)
- …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. + Ability ... with service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management? + No… more
- Baystate Health (Springfield, MA)
- …meetings to address treatment objectives. **6.** May collaborate as assigned with utilization review specialist to obtain necessary insurance authorizations and ... Emergency Department Crisis Clinician **Up to $5,000 sign-on bonus (external applicants...for gathering a psychosocial evaluation through interviews and record review and completing a written assessment with case formulation… more
- Molina Healthcare (KY)
- …are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- Hartford HealthCare (Torrington, CT)
- …Licensed Clinician provides individual, group, couples, and family therapy. Utilization of evidenced based practices are supported. Clinicians are encouraged to ... in a convenient, safe and comfortable patient environment. The Licensed Psychiatric Clinician is a Masters prepared Licensed Clinical Social Worker (LCSW), Licensed… more
- Molina Healthcare (Long Beach, CA)
- …will move to a 3 day/12 hour shift from then on._** **_Previous experience with Utilization Management / Utilization Review is very essential to this role. ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- Molina Healthcare (TX)
- …are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review / Utilization Review / Utilization Management and knowledge ... of Interqual / MCG guidelines. COMPACT RN LICENSURE IS PREFERABLE to support multiple states.** **Excellent computer skills and attention to detail are very important to multi task between systems, talk with members on the phone, and enter accurate contact… more
- Wheeler Clinic (Hartford, CT)
- Part Time Gambling Disorders Clinician Hartford, CT, USA Req #1230 Wednesday, June 5, 2024 Wheeler's vision is that all people will have the opportunity to grow, ... of life. POSITION SUMMARY The Part Time Bettor Choice Integrated Health Care Clinician provides clinical and case management services adults 18+ in an integrated… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
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