- El Paso County (Colorado Springs, CO)
- Utilization Reviewer - Behavioral Health Print (https://www.governmentjobs.com/careers/elpasocountyco/jobs/newprint/4719458) Apply Utilization ... and individuals with intellectual and developmental disabilities (IDD). Examines cases from a behavioral health perspective and provides behavioral health… more
- 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
- 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
- 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 ... us transform healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have… more
- Sutter Health (Berkeley, CA)
- …and others to ensure appropriate utilization and quality care through utilization review , tracking and evaluation and objectively compare criteria with ... clinical nursing staff and other departments regarding documentation required for utilization review activities and processes. Collaborate with medical, nursing… more
- 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
- Kepro (AR)
- …behavior. + 2+ years of experience in a behavioral health setting, conducting behavioral health utilization reviews or behavioral health case ... the public sector. Acentra is looking for a Clinical Reviewer - Behavioral Health -... review of clinical records. Preferred Qualifications/Experience: + Utilization Review / Utilization Management experience. +… more
- St. Peters Health (Helena, MT)
- …and crises, stress-related physical symptoms and ineffective patterns of healthcare utilization . Behavioral health services include assessment, treatment ... The Behavioral Health Professional Licensure Candidate Per Diem (BHP) is an integral member of the primary care team who works to identify, triage and support… more
- 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 (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
- 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
- CVS Health (Austin, TX)
- …other agency/stakeholder meetings when requested. - Oversight and implementation of the utilization management program for behavioral health services, ... care more personal, convenient and affordable. **Position Summary** The Behavioral Health Medical Director is a key...health denials, including state fair hearings and external review organizations. - Review and resolution of… more
- CVS Health (Baton Rouge, LA)
- …other agency/stakeholder meetings when requested. * Oversight and implementation of the utilization management program for behavioral health services, ... of Louisiana is seeking a dedicated and experienced Behavioral Health Medical Director. The ideal candidate...health denials, including state fair hearings and external review organizations. * Review and resolution of… more
- 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
- 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
- Elevance Health (Cerritos, CA)
- The **Manager II Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health Case ... cost of care initiatives. + May attend meetings to review CM processes. + Hires, trains, coaches, counsels, and...+ MS in social work, counseling, psychology or related behavioral health field or a degree in… more
- 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
- Immigration and Customs Enforcement (IN)
- …are in conjunction with IHSC/ICE policy and standards. Approval authority for appropriate utilization of all regional behavioral health personnel response to ... Service Corps (IHSC), Office of the Deputy Assistant Director of Clinical Services, Behavioral Health Unit. This is a supervisory position. This position is… more
- 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
- Banner Health (AZ)
- …or other staff of non-company locations on concurrent and retrospective utilization review . Accurately and thoroughly completes documentation required for ... Registered Nurse and your knowledge of Case Managment and Utilization Management to review clinical records to...(RN) licensure in the state of practice. In a Behavioral Health setting requires Registered Nurse (RN)… more