• Behavioral Analysis

    CVS Health (Tallahassee, FL)
    …**_Must reside in state of Florida, position is 100% remote._** Behavior Analysis Utilization Management Clinical Consultant applies critical thinking ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to Behavior Analysis . Utilizes clinical… more
    CVS Health (11/13/24)
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  • Utilization Management Clinical…

    CVS Health (Phoenix, AZ)
    …to make health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work schedules will include ... weekend, holidays, and evening rotations. ABA Utilization Management Clinical Consultant applies critical thinking...degree in Nursing or Master's degree in Applied Behavior Analysis , Social Work, Psychology or Behavioral Health… more
    CVS Health (11/21/24)
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  • Utilization Management Clinician,…

    CVS Health (Austin, TX)
    …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3 years of ... standard business hours. No nights, weekends or holidays.** **As a UM Clinician Behavioral Health you will:** + Utilize clinical experience and skills in a… more
    CVS Health (11/23/24)
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  • Utilization Review RN for Behavioral

    AdventHealth (Glendale Heights, IL)
    …Oversees and coordinates compliance to federally mandated and third-party payer utilization management rules and regulations. Qualifications **The expertise and ... role you'll contribute:** Provides health care services regarding admissions, case management , discharge planning and utilization review. **The value you'll… more
    AdventHealth (11/09/24)
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  • Behavioral Health Care Manager II - UM…

    Elevance Health (FL)
    …PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
    Elevance Health (11/09/24)
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  • BH Care Manager I - Applied Behavioral

    Elevance Health (Durham, NC)
    …insightful analytics to improve the delivery of care. **BH Care Manager I (Applied Behavioral Analysis ) - North Carolina** Candidate must live AND be licensed in ... rotating Holiday coverage.** The **BH Care Manager I (Applied Behavioral Analysis )** is responsible for managing psychiatric...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
    Elevance Health (11/07/24)
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  • Utilization Mgmt ED RN - Case…

    Stanford Health Care (Palo Alto, CA)
    …**This is a remote Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring ... the institution, navigating the complexities of patient care and resource utilization management , and education. Primary responsibilities include: 1.… more
    Stanford Health Care (09/21/24)
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  • Utilization Management Specialist…

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates,… more
    CareFirst (11/07/24)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/ analysis , ... mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years… more
    US Tech Solutions (10/31/24)
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  • Utilization Manager

    Acacia Network (Bronx, NY)
    …degree required (Bachelor's Degree preferred) + Minimum of 2 years of case management and/or utilization review experience + Strong problem-solving and advanced ... Acacia Network Inc. Utilization Manager Bronx, : 5/30/2024 Job Description Job...the community, from children to seniors, a pathway to behavioral and primary healthcare, housing, and empowerment. We are… more
    Acacia Network (08/30/24)
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  • Quality Management Consultant…

    CVS Health (Tallahassee, FL)
    …will require manipulation and analysis of data to support behavioral health initiatives on the quality management team. **Responsibilities include:** ... records or systems to document root cause of high utilization of care. The QM BH Consultant develops and...collection and review of case and medical records for behavioral health quality activities, including root cause analysis more
    CVS Health (11/24/24)
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  • Manager II Behavioral Health Services

    Elevance Health (Hermitage, PA)
    …locations. The **Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... following criteria are met; performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff… more
    Elevance Health (11/15/24)
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  • Psychiatrist Senior Medical Director…

    UPMC (Moosic, PA)
    …consultation with practitioners in the field. This includes significant responsibility for quality management and utilization management and for assuring the ... you will assure the quality and efficiency of the behavioral health care delivered to Community Care members. Incorporated...protocols. + Review the medical aspects of cost and utilization reports generated by Medical Management Information… more
    UPMC (09/25/24)
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  • Behavioral Health Clinical Liaison-SMI

    CVS Health (Tallahassee, FL)
    …Aetna state Medicaid plan. This may include substance use disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered Services, and ... the plan and works across various departments including Care Management , Utilization Management , Quality ... Management , Quality Management , and Medical Management on issues related to Behavioral Health.… more
    CVS Health (11/16/24)
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  • Behavioral Health Provider (O-5 Billet)…

    Immigration and Customs Enforcement (Jena, LA)
    …manage serious mental illness (SMI) caseload. Provides on-site counseling, psychotherapy, behavioral analysis , substance abuse education, and therapy as ... Service Corps (IHSC), Office of the Deputy Assistant Director of Clinical Services, Behavioral Health Unit. This position is supervisory. This position is only open… more
    Immigration and Customs Enforcement (11/09/24)
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  • Behavioral Health Liaison

    CVS Health (Tallahassee, FL)
    …internal/external clinician support as required including working with the Care Management and Utilization Management teams. **Position Responsibilities:** ... health care more personal, convenient and affordable. **Position Summary:** The Behavioral Health Liaison directs coordination of care between the Aetna benefits… more
    CVS Health (11/24/24)
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  • Dir, Behavioral Health (must reside in OH)

    Molina Healthcare (Columbus, OH)
    …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **KNOWLEDGE/SKILLS/ABILITIES** + Serves as… more
    Molina Healthcare (11/02/24)
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  • Diversion Behavioral Health Coordinator

    Spokane County (Spokane, WA)
    Diversion Behavioral Health Coordinator Print (https://www.governmentjobs.com/careers/spokanecountywa/jobs/newprint/4723602) Apply  Diversion Behavioral Health ... allocated to this classification is responsible for overseeing program implementation analysis , development, and operations of carceral and criminal legal diversion… more
    Spokane County (11/17/24)
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  • Senior Medical Director, Behavioral Health…

    Magellan Health Services (Albuquerque, NM)
    …the delivery of appropriate health care by overseeing the service coordination, utilization management , care/case management , population health/disease ... cost of care of clinical programs through review and analysis of utilization and financial data., Assists...overseen by the assigned position which includes metrics for utilization and quality management . Develops mitigating strategies… more
    Magellan Health Services (10/02/24)
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  • Behavioral Health Account Manager

    Healthfirst (NY)
    …Health Homes, Claims, Authorizations, Cultural Competency, Evidence Based Practices, Utilization Management , HCBS eligibility/assessment and the secure provider ... + Assists in the development and recruitment of the Behavioral Health network based on department needs and Healthfirst priorities. + Negotiates and executes Single… more
    Healthfirst (10/24/24)
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