• Utilization Review Clinician

    Centene Corporation (Frankfort, KY)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (01/10/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Lexington, KY)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan 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 (12/20/24)
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  • Utilization Management Clinical Consultant…

    CVS Health (Frankfort, KY)
    …in state of Kentucky **Preferred** **Qualifications:** + Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient ... personal, convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant. **MUST RESIDE IN KENTUCKY** + Utilizes… more
    CVS Health (01/11/25)
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