• Supervisor , Utilization

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …role directly manages 5-10 This role reports to this job: Manager, Behavioral Health Operations Necessary Contacts: In order to effectively fulfill this position, ... related field, masters in social work, counseling, or other behavioral health related field is required. + Current, unrestricted...experience is required. **Skills and Abilities** + Ability to review claims history in a medical claims system and… more
    Blue Cross and Blue Shield of Louisiana (06/20/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Tallahassee, FL)
    …ABA TEAM IDEAL CANDIDATE WILL HAVE BCBA CERTIFICATION **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure ... activities of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable… more
    Centene Corporation (06/26/25)
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  • Behavioral Health Utilization

    Actalent (Sunrise, FL)
    …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... Working under the general supervision of the Director and/or Manager/ Supervisor of Medical Management, and in collaboration with an...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
    Actalent (06/21/25)
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  • Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The UR ... case conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or Master's… more
    Spectrum Billing Solutions (06/05/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (LA)
    …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
    AmeriHealth Caritas (06/25/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Washington, DC)
    …to efficiently document and assess patient cases + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... **Role Overview** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization...ability to meet productivity standards in a fast-paced, high-volume utilization review environment The range displayed in… more
    AmeriHealth Caritas (06/03/25)
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  • Utilization Review Registered Nurse…

    BJC HealthCare (St. Louis, MO)
    …nurse experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... shifts. No patient communication. The position will support all units/staff (commercial, behavioral health, inpatient, ect) **Requirements:** + 2 years of staff… more
    BJC HealthCare (06/24/25)
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  • Pediatric Shift Care Utilization Management…

    AmeriHealth Caritas (Philadelphia, PA)
    **Role Overview** Under the direction of the unit Supervisor , the Clinical Care Reviewer- Shift Care is responsible for managing requests for pediatric shift care ... parent/guardian to complete a comprehensive assessment of the member's medical, behavioral , and social needs.; **Responsibilities** + Using clinical knowledge and… more
    AmeriHealth Caritas (05/22/25)
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  • Behavioral Program Supervisor

    Sevita (Beverly, MA)
    …children and adolescents with Autism Spectrum Disorders and other related disorders. ** Behavioral Program Supervisor ** Do you have strong leadership skills? Are ... Provide administrative supervision and guidance of the Behavior Analysts and Behavioral Intervention Therapy Department. + Supervision of assigned staff includes… more
    Sevita (06/14/25)
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  • Behavioral Program Supervisor

    Sevita (West Boylston, MA)
    …and families, join our mission-driven team and experience a career well lived. ** Behavioral Program Supervisor ** Do you have strong leadership skills? Are you ... part of the Sevita family** , provides community and center-based Applied Behavioral Analysis (ABA) services to individuals with Autism Spectrum Disorder (ASD) and… more
    Sevita (06/04/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
    Helio Health Inc. (05/30/25)
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  • Utilization Management Services Rep…

    Excellus BlueCross BlueShield (Rochester, NY)
    …you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. ... Care Advance Provider Tool, and fax for inpatient and outpatient procedures, behavioral health, and durable medical equipment. Essential Accountabilities: Level I +… more
    Excellus BlueCross BlueShield (05/29/25)
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  • Behavioral Health Provider (O-6 Billet)…

    Immigration and Customs Enforcement (Eloy, AZ)
    …Risk management, etc.) and work collaboratively to address the same. Participates in review of behavioral health processes and procedures within the facility; ... Service Corps (IHSC), Office of the Deputy Assistant Director of Clinical Services, Behavioral Health Unit (BHU). This position is supervisory. This position is only… more
    Immigration and Customs Enforcement (06/03/25)
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  • Secretary II, Adolescent Ambulatory…

    Eastern Connecticut Health Network (Manchester, CT)
    …and expeditious retrieval of information, as evidenced by staff feedback, chart review , regulatory reviews and supervisor observation. + Is courteous and ... the Administrative Manager and indirectly to the Director of Ambulatory Behavioral Health Services. Provides administrative support for clinical, management, medical… more
    Eastern Connecticut Health Network (05/08/25)
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  • Director, Center for Behavioral Medicine

    Lawrence General Hospital (Methuen, MA)
    …and change management. + Experience working in a managed care environment including utilization review processes. + Experience working in a union environment. + ... JOB PURPOSE: The Center for Behavioral Medicine Director will be responsible for providing...communicates learning, competency and personal development needs to the supervisor . + Actively identifies and participates in educational activities… more
    Lawrence General Hospital (06/26/25)
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  • Administrative Director for Behavioral

    East Boston Neighborhood Health Center (MA)
    …the preparation and monitoring of the departmental budget; BHC productivity/ utilization review , and documentation/coding/billing practices and improvements. ... Locations: 1601 Washington Street Position Summary: Under the direction of the Chief Behavioral Health Officer, the Administrative Director is an agent of change who… more
    East Boston Neighborhood Health Center (06/26/25)
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  • Behavioral Health Director - College…

    Lake Erie College of Osteopathic Medicine (Erie, PA)
    …of psychiatric diagnostic criteria and differential diagnoses; + Awareness of the utilization of psychological methodologies; + Ability to review the work ... Behavioral Health Director - College of Medicine Overview...federal regulations; + Attends regularly scheduled meetings with administrative staff/ supervisor ; + Participates in other programming as requested and… more
    Lake Erie College of Osteopathic Medicine (05/29/25)
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  • Director of Behavioral Health - College…

    Lake Erie College of Osteopathic Medicine (Erie, PA)
    …through those agencies; + Attends regularly scheduled meetings with administrative staff/ supervisor ; + Directs the Behavioral Health Module for students ... Director of Behavioral Health - College of Medicine Overview Date...order to realize differential diagnoses; + Competent with the utilization of psychological methodologies; + Ability to review more
    Lake Erie College of Osteopathic Medicine (05/29/25)
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  • Behavioral Health Service Provider

    OLV Human Services (Lackawanna, NY)
    …health record (EHR) for documentation of services rendered. + Review utilization and service provision with supervisor + Coordinate and collaborate with ... Salary range: $18.22 - $26.00 per hour. The Youth Behavioral Support Caseworker provides direct services to children and...others. + Any other duty as assigned by your Supervisor Skills: + Teamwork: Ability to work as part… more
    OLV Human Services (06/06/25)
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  • Part-time/PRN Behavioral Health…

    BriteLife Recovery (Hanover, PA)
    …+ Under direction of supervisor , establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, limit ... "PRN" BEHAVIORAL HEALTH TECHNICIAN/DRIVER Do you work for a...follow the direction of the Clinical Director and BHT Supervisor and safely transport clients in a timely fashion… more
    BriteLife Recovery (06/21/25)
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