• Applied Behavioral Analysis

    Humana (Tallahassee, FL)
    …of Applied Behavioral Analysis clinical experience + Minimum 2 years utilization management Applied Behavioral Analysis reviewing services + ... caring community and help us put health first** The Utilization Management Behavioral Health Professional...managed care experience + 5 years' experience with Applied Behavioral Analysis + Knowledge of community health… more
    Humana (12/05/24)
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  • 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 (01/04/25)
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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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  • Utilization Analyst Case Management

    Beth Israel Lahey Health (Burlington, MA)
    …job, you're making a difference in people's lives.** **Job Description:** The Utilization Analyst works with physicians, the payers and inpatient case management ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
    Beth Israel Lahey Health (12/10/24)
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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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  • Care Manager (SUD utilization review…

    Magellan Health Services (Boise, ID)
    …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... candidates that live in Idaho. Also interested in candidates with SUD utilization review experience. Under general supervision, and in collaboration with other… more
    Magellan Health Services (12/04/24)
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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 (12/20/24)
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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 (12/25/24)
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  • Senior Clinical Strategist / Behavioral

    CVS Health (Trenton, NJ)
    …role requires experience and familiarity with Substance Use Disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered services, ... 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 (01/07/25)
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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 Informatics & Electronic…

    Ventura County (Ventura, CA)
    …operational need and certification of skill. DEPARTMENT/AGENCY: Health Care Agency - Behavioral Health Staff/Services Manager III is a Management classification ... Behavioral Health Informatics & Electronic Health Record Manager...tools + Principles and techniques of budgetary preparation and analysis , fiscal management , organization and staffing +… more
    Ventura County (01/01/25)
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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 (12/31/24)
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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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  • Medical Director, Behavioral Health (Part…

    Magellan Health Services (San Diego, CA)
    …appropriate for complex case management and timely completion of all utilization management activities. Involvement in the development of case management ... plans. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
    Magellan Health Services (12/24/24)
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  • Behavioral Health Masters Clinician…

    Dartmouth Health (Keene, NH)
    …physician practice, while emphasizing care coordination across the continuum. Perform utilization management activities as necessary to ensure that medical ... Functioning as a member or the Behavioral Health Team, the Master's Level Clinician, in...critical pathways and outcome measurement preferred. Experience in case management , utilization review and discharge planning preferred.… more
    Dartmouth Health (10/28/24)
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  • Therapist- Behavioral Health

    LifePoint Health (Hickory, NC)
    Job Summary The Behavioral Health Clinical Program Therapist functions as a member of the Behavioral Health Team in providing independent practice license scope ... levels of psychiatric care for the patients on the Behavioral Health Units. Provides and documents mental health services to Psychiatric patients. Develops and… more
    LifePoint Health (12/19/24)
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  • Sr. Administrative Officer, Psychiatry…

    University of Miami (Miami, FL)
    … Sciences generates, manages, and interprets strategic information; provides financial management and accountability for all Psychiatry & Behavioral Sciences ... opportunity for a Full-time Sr. Administrative Officer, Psychiatry & Behavioral Health Sciences to work in Miami. The Sr....the business of the Department. + Oversees the administrative management of clinical programs to include analysis more
    University of Miami (11/05/24)
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  • Area Vice President - Behavioral

    Maxim Healthcare Services (San Antonio, TX)
    …Vice President (AVP) for our Behavioral division in Texas. Maxim's applied behavioral analysis (ABA) care is offered in home, school or community-based ... environments. Our behavioral care uses a flexible, empathy-based approach consisting of...The Area Vice President leads operation teams, drives performance management and market development within an assigned geographic area,… more
    Maxim Healthcare Services (12/14/24)
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  • Behavioral Health Program Coordinator-1

    Point32Health (MA)
    …Health functions as a key member of the Program Coordinator Team and the BH Utilization Management department and is a representative of Point32 Health values to ... (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the direction of the Supervisor - Behavioral Health is responsible for the daily management of… more
    Point32Health (01/03/25)
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  • Behavioral Health Clinical Quality Audit…

    Elevance Health (Seven Fields, PA)
    …or related field and a minimum of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed ... + Analyzes data and prepares concise, accurate and meaningful quality management reports in accordance with Company procedures. + Defines opportunities for… more
    Elevance Health (01/02/25)
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