- Christus Health (Santa Fe, NM)
- …individual also negotiates length of stay with managed care organizations and performs Utilization Review functions. Serves as liaison with local and surrounding ... and external sources to enhance outcomes. Requirements EDUCATION: Licensed Clinician (Nursing, Occupational Therapist, Physical Therapist, or Speech Language… more
- Novant Health (NC)
- What We Offer Why This Role Matters As a Utilization Review Clinician , you will play a critical role in ensuring the integrity and compliance of patient ... needed, most holidays required. + Serve as a leader resource in the Utilization Review process for Behavioral Health acute care . + Coordinate and conduct… more
- Centene Corporation (Salem, OR)
- …and substance abuse preferred. **Knowledge of mental health and substance abuse utilization review process preferred.** Experience working with providers and ... **Hours: Monday-Friday: 8am-5pm or 9am-6pm PST.** **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Centene Corporation (Phoenix, AZ)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. 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 (Harrisburg, PA)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. 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
- CenterWell (Columbia, SC)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics + Review clinician schedules and incentive plans to… more
- CenterWell (Arlington, TX)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- CenterWell (Daytona Beach, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
- CenterWell (Kansas City, KS)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization . + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization . + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- CVS Health (Harrisburg, PA)
- …Monday through Friday 8:30-5pm . No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health ... **Position Summary-** + **Master's Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and Licensed Registered Nurse with Psychiatric… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... Integrated Outpatient Senior Clinician FLACRA Penn Yan, NY (Onsite) Full-Time $34.00/Hour...plus. Valid NYS driver's License. Job Summary:The integrated senior clinician is a clinician with demonstrated leadership… more
- Molina Healthcare (Louisville, KY)
- …RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and ... JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
- City of Durham (Durham, NC)
- …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. + Ability ... Crisis Response Clinician Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5167824) Apply Crisis Response Clinician Salary $66,703.00 -… more
- Elevance Health (Louisville, KY)
- …or equivalent. Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... **Medical Management Clinician Senior** **Location:** This role enables associates to...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses… more
- Hartford HealthCare (Danielson, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and then to the student's home. *_Job Summary_* Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare, and deliver… more
- Elevance Health (Miami, FL)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. Current active, valid and unrestricted LPN/LVN license ... Med Management Clinician Senior- Licensed Nurse **Location:** Miami, FL **Hybrid...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses… more
- Molina Healthcare (Covington, KY)
- …or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (North Las Vegas, NV)
- …care unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Insight Global (Piscataway, NJ)
- …support the group. Each group is 1 hour long and they will do documentation and utilization review during the other hours they are not face to face with clients. ... Job Description Insight Global is looking for Mental Health Clinician II for a Mental Health outpatient facility in Piscataway, NJ for their partial hospitalization… more
- Molina Healthcare (Sparks, NV)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
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