- The Cigna Group (Bloomfield, CT)
- …several health -related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, ... the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked...or in direct provision of service as a mental health or chemical dependency counselor. As an Inpatient… more
- AmeriHealth Caritas (Charlotte, NC)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... Using clinical knowledge and experience, the Clinical Care Reviewer UM reviews the provider requests for inpatient ...care coordination opportunities and refer those cases to Population Health as needed. The Clinical Care Reviewer UM… more
- Magellan Health Services (Honolulu, HI)
- …LCSW, LSW, LPC or RN. Minimum 2 years experience post degree in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong ... the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient...General Job Information Title HMSA Care Manager - BH, UM Reviewer - Remote Hawaii Grade 24 Work Experience… more
- Molina Healthcare (Los Angeles, CA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... a candidate with a RN license and managed care UM experience-required. Prior Inpatient review experience and...experience and transplants highly preferred. Strong skills with Electronic Health systems and computer software to meet daily work… more
- Kepro (AR)
- … UM reviews such as: Inpatient (Under 21) and Outpatient Behavioral Health , Pediatric Developmental Disability Services, Personal Care Services, Applied ... CNSI and Kepro are now Acentra Health ! Acentra Health exists to empower...provide day-to-day oversight to manage multiple areas of the UM program and oversee the implementation of clinical contract… more
- LifePoint Health (Las Cruces, NM)
- …the discharge plan. * Discharge Planning assists with LTC, SNF, Rehabilitation, Behavioral /Mental Health , Home Care, DME, transportation and other placement ... of care, including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. *Where We Are:* From national parks and monuments… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …The Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral health resource management to review and coordinate the ... party payers to obtain certification for medically necessary acute inpatient hospitalization and to facilitate transfer to the appropriate...+ Minimum five years of clinical experience in a behavioral health care setting. + Excellent written… more
- WellSpan Health (Mount Gretna, PA)
- Manager Behavioral Health Services - Adult Inpatient Services - Days Location: WellSpan Philhaven, Mount Gretna, PA Schedule: Full Time Full time (80 hours ... position that is responsible for the functioning of the assigned Inpatient Program and that provides administrative and clinical leadership for operation… more
- Elevance Health (Tampa, FL)
- …Management (BH CM) The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM ), or Behavioral ... if all of the following criteria are met; performs UM approvals only, reviews requests for Applied Behavioral...+ MS in social work, counseling, psychology or related behavioral health field or a degree in… more
- Elevance Health (Olathe, KS)
- …coordinators (CM) and one will be responsible for overseeing a team of care managers ( UM ).** The **Manager of Behavioral Health ** is responsible for ... Behavioral Health Utilization Management (BH UM ), or Behavioral Health Case...to ensure medical necessity and appropriateness of care for inpatient /outpatient BH services. + Ensures appropriate utilization of BH… more
- Molina Healthcare (San Jose, CA)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost...teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other… more
- Molina Healthcare (Sacramento, CA)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... Rotating weekends and holidays will be required._** **_This position supports our California Health Plan. Candidates can live anywhere in the USA if they have a… more
- Molina Healthcare (Bowling Green, KY)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses inpatient services for members to ensure optimum outcomes, cost...teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other… more
- Stanford Health Care (Palo Alto, CA)
- …for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices. ... the Department's functions and overall business operations. Directs, manages, and supervises UM Department staff **Locations** Stanford Health Care (Palo Alto,… more
- Stanford Health Care (Palo Alto, CA)
- …for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices. ... of America) Why work at Stanford Medicine | Stanford Health Care (SHC)? Here is your opportunity to work...your opportunity to work with the unique and supportive UM team. You can put your knowledge about Medicare,… more
- Magellan Health Services (Newtown, PA)
- …clinical program(s). + Provides Magellan team with information on the treatment of behavioral health , chronic pain, substance abuse such as opioid addiction, ... for our members. + Reviews authorization requests for children's community-based services: Behavioral Health Rehabilitative Services and Applied Behavioral … more
- University of Michigan (Ann Arbor, MI)
- …and considered for the position. **Desired Qualifications + Emergency department or inpatient behavioral health experience + Extensive knowledge about ... PSYCHIATRY Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities through excellence in education,… more
- Access Dubuque (Dubuque, IA)
- RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID: 36229590 Posted On 07/10/2024 **Job Overview** **Overview** The Care Coordinator integrates ... for the individual and their support systems. **Why UnityPoint Health ?** + **Commitment to our Team -** We've been...education. **Utilization Management/Revenue Cycle** + Applies the utilization management ( UM ) plan by functioning in the UM … more
- Dignity Health (San Bernardino, CA)
- …in San Bernardino California. Known for its programs in maternity care and pediatrics behavioral health and long-term subacute care for adults and children the ... **Overview** Founded in 1910 Dignity Health - Community Hospital of San Bernardino is...hospital also includes inpatient and outpatient surgery. The hospital shares a legacy… more
- CareFirst (Baltimore, MD)
- … intake and call center, Commercial outpatient medical pre-authorization review, Commercial inpatient and outpatient behavioral health review, Medicare ... engagement, improve access to quality care and the use of cost-effective health resources. Will be responsible for the Commercial, Federal Employee Program,… more