- Molina Healthcare (Austin, TX)
- …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …A minimum of 1 year experience as a psychiatric nurse. 1-2 years-experience in behavioral health utilization review preferred. AGENCY SUMMARY: Bluestone is ... our employees and their families, including domestic partners. Our offerings include: Comprehensive health and Rx plans, including a flat rate ($5, $10, $15) option.… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …work rotating shifts, holidays and weekends * Tuberculosis testing is completed upon hire and additionally as required Department: Behavioral and Mental Health ... experience, education, and other business and organizational considerations. Department: Care Management Services FTE: 1.00 Full Time Shift: Days Position Summary:… more
- MVP Health Care (Rochester, NY)
- …For in New York , and an Inclusive Workplace . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health ... improvement. To achieve this, we're looking for a Professional, Behavioral Health to join #TeamMVP. If you...adolescents, with at least 2 years being ASD related Utilization or Case Management experience in a… more
- Luminis Health (Annapolis, MD)
- Luminis Health : Anne Arundel Medical Center Title: Team Leader RN - Cardiac OR Reports to: Clinical Nursing Director of the Operating Room and Surgeon Leader Cost ... coordinate the availability of supplies, instruments, and equipment; ensure appropriate utilization of these resources; and (to the extent possible) standardize use… more
- Premise Health (Pleasanton, CA)
- …time, a company-sponsored wellness program, EAP, access to virtual primary care and virtual behavioral health at no cost for team members and their dependents. ... hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com. As a… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing ... products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The ... monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with initial assessments, as… more
- CVS Health (Oklahoma City, OK)
- …+ Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to multitask, prioritize and ... every day. **_Work at home Position-Must Reside in Oklahoma_** **Position Summary: Behavioral Health Clinical Reviewer (LCSW, LCPC, RN)** Licensed clinical… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …a member's benefit coverage while working remotely. Primary Responsibilities * Performs behavioral health clinical utilization reviews using evidenced based ... About The Role BHPS provides Utilization Management services to its clients....* Experience with both inpatient and outpatient reviews for Behavioral Health (examples: TMS, ECT, ABA, Psychotherapy,… more
- CVS Health (Oklahoma City, OK)
- …stakeholders to identify and address patient needs (eg care team, social work, behavioral health , utilization management , Hard-to-Reach, Central ... follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and...we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management , Care Management , Quality, and… more
- Humana (Indianapolis, IN)
- …administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and ... specialists + Develops comprehensive care programs for the management of adult behavioral health ...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
- Molina Healthcare (Dayton, OH)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- Adecco US, Inc. (Minneapolis, MN)
- …decisions, rationale, and alternative treatment options. * Assist callers routed to the Behavioral Health Utilization Management department and resolve ... of providers and members for all authorization requests. * Input and prepare Behavioral Health and Substance Use Disorder authorizations across all lines of… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- Centene Corporation (Sacramento, CA)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...policies and standards. We are seeking a Licensed Clinical Behavioral Health Professional or RN to join… more
- Tenet Healthcare (Detroit, MI)
- … Health patient care experience required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN ... national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention… more
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
