- MVP Health Care (Tarrytown, NY)
- …. The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This ... the difference for our customers in every interaction Your key responsibilities: Review all requests for behavioral health services utilizing the appropriate… more
- Centene Corporation (Sacramento, CA)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …mental health and co-occurring psychiatric and substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $31.50-37.50 Per ... monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates… more
- Centene Corporation (Harrisburg, PA)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... state (BCBA) required. Master's degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under direction, the 2932 Senior Behavioral Health Clinician performs essential duties that include, but are not ... and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties as...techniques. + Knowledge of clinical methods refers to the utilization of the history, culture, socioeconomic background, and environment… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under general supervision, the 2930 Behavioral Health Clinician performs essential duties that include, but are not ... of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than...Housing and the Department of Public Health can then review your application and contact you directly with details… more
- Dartmouth Health (Keene, NH)
- …critical pathways and outcome measurement preferred. Experience in case management, utilization review and discharge planning preferred. Knowledge of JCAHO/NCQA ... Functioning as a member or the Behavioral Health Team, the Master's Level Clinician...is sensitive to patient needs and expectations, promote effective utilization of resources, and support physician practice, while emphasizing… more
- Atlantic Health System (Morristown, NJ)
- The Behavioral Health Clinician position in our Collaborative Care Program serves as an integrated member of the team at our Internal Medicine Faculty ... relapse prevention, and self-management strategies. 04. Provides brief, evidence-based behavioral interventions such as behavioral activation, cognitive behavior… more
- Centene Corporation (Jefferson City, MO)
- …applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA ... of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - Licensed Practical… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient services, working closely with… more
- Molina Healthcare (Louisville, KY)
- …RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization for outpatient and ... DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible...teams to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work… more
- State of Colorado (Denver, CO)
- Mental Health Clinician III (Staffing Office) - Colorado Mental Health Hospital Fort Logan (Denver) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5153605) Apply Mental Health Clinician III (Staffing Office) - Colorado Mental Health Hospital Fort… more
- Hartford HealthCare (Danielson, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and then to the student's home. *_Job Summary_* Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare,… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... Integrated Outpatient Senior Clinician FLACRA Penn Yan, NY (Onsite) Full-Time $34.00/Hour...staff and community service providers. + Knowledge of local behavioral health service system. + Ability to multi-task, have… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …providers to ensure appropriate service utilization . The Placement Stabilization Clinician works closely with the Behavioral Health Unit to coordinate ... Home Levels, high end, and specialized placement settings. 2. Comprehensive Clinical Review : In partnership with the Behavioral Health and MDT coordinators,… more
- Molina Healthcare (NM)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... degree in a healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of… more
- HCA Healthcare (Falls Church, VA)
- …guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with Process and Quality ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...we encourage you to apply for our Licensed Assessment Clinician - PRN opening. We promptly review … more
- Molina Healthcare (Akron, OH)
- **JOB DESCRIPTION** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Highmark Health (Little Rock, AR)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Helio Health Inc. (Syracuse, NY)
- …for this population. + Actively participate in daily team meetings for status review , service plan updates and staff assignments. + Update case records daily. + ... in-home and community-based services + Strong background in recovery-based and person-centered behavioral health services + Must have a valid driver's license and… more
