- 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 (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 (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
- 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
- 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 (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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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