- Geisinger (Wilkes-Barre, PA)
- …new emergency treatment roomsCreating dedicated emergency room (ER) space for behavioral health patientsExpanding trauma capabilities24 new intensive care unit ... new skills focused on the specialized practice settingFree Princeton NCLEX Review Questions (on-line, self paced)!Temporary Practice Permit (TPP) reimbursement +… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …Process and therapeutic use of self. The LPN assesses and monitors patient's health status and physical care needs at admission and while client's are receiving ... management of medication and other patient care supplies. The LPN also provides health education for patients and families as needed or requested. They function as… more
- InterDent (Amboy, WA)
- …value-based care initiatives, alternative payment methodologies (APMs), and medical-dental- behavioral health integration programs. Provide clinical mentorship, ... and comprehensive dental services to children and low-income populations under the Oregon Health Plan, with a strong focus on improving both oral and systemic … more
- SR International, Inc. (Phoenix, AZ)
- …*Medical nursing practice, medical case management protocols, quality management and utilization review protocols as related to all populations including ... pertaining to the AHCCCS program *Good written and communication skills *Computer skills * Utilization Review skills *Medical Claims Review skills *Producing… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... department activities as assigned. Essential Skills + Experience in utilization management, behavioral health , and...mental health . + Proficiency in clinical and utilization review processes. + Current unrestricted Florida… more
- Centene Corporation (Raleigh, NC)
- …FOR WEEKEND AND HOLIDAY ROTATIONS**'** MUST HOLD NORTH CAROLINA BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- Humana (Frankfort, KY)
- …+ Psychologist **(PhD)** **Preferred Qualifications** + Experience with utilization review process + Outpatient Behavioral Health experience (mental ... of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health … more
- CVS Health (OH)
- …**Preferred Qualifications** + Utilization review experience strongly preferred + Behavioral health experience + Experience in a behavioral health ... state of Ohio. The requirements is for candidates to hold a Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with… more
- Centene Corporation (Phoenix, AZ)
- …at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care ... within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines… more
- UnityPoint Health (Cedar Rapids, IA)
- …regarding managed care implications - precertification and utilization review procedures. . Provides consultation regarding behavioral health ... the assessment, planning, implementation and evaluation of patient care on the behavioral health units. Responsible for the delivery of patient care through a… more
- Cambridge Health Alliance (Somerville, MA)
- …MNA Somerville **This position in onsite in Somerville** Department Description: Utilization review (UR) in behavioral health that evaluates the medical ... Case Manager will collaborate with other members of the health care team to identify appropriate utilization ...the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria… more
- CVS Health (KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state of Kentucky or ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
- CVS Health (Workman, MN)
- …we do it all with heart, each and every day. **Position Summary** As a Utilization Management Clinician - Behavioral Health you will utilizes clinical ... and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LSW, LISW,...and substance abuse disorders + Managed care experience + Utilization review experience + Crisis intervention skills… more
- CVS Health (AZ)
- …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
- Omaha Children's Hospital (Omaha, NE)
- …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. * Appropriately documents all relevant communications… more
- Omaha Children's Hospital (Omaha, NE)
- …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. o Appropriately documents all relevant communications… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- …If you answered YES, then consider joining our Devereux Advanced Behavioral Health team! Being a Utilization Review Specialist at Devereux has ... helping individuals in need. Devereux's Children Behavioral Health Center (DCBHC) is currently seeking a Utilization... Health Center (DCBHC) is currently seeking a Utilization Review Specialist to work at their… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Spectrum Billing Solutions (Skokie, IL)
- …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250930-5612FP-001 Location Hartford, CT Date Opened 10/2/2025 12:00:00 AM Salary $78,480* - ... Services (DMHAS (https://portal.ct.gov/dmhas) ), is seeking to hire a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&LinkSpec=RecruitNum2&R1=&R3=) at the Blue… more
