- CVS Health (Phoenix, AZ)
- …meaningful difference in the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a ... with Arizona Department of Child Safety (DCS). + Knowledge of Behavioral Health Outpatient Services. + Utilization Management (UM) Experience. **Education**… more
- Elevance Health (Louisville, KY)
- … management The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM). **How you will make an ... **Additional requirements for BH UM:** MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5… more
- Centene Corporation (San Antonio, TX)
- … health and substance abuse is preferred. + Utilization Review/ Utilization management with behavioral health cases + Precertification, Concurrent ... regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall...and substance abuse is preferred. + Knowledge of mental health and substance abuse utilization review process… more
- Brockton Hospital (Brockton, MA)
- POSITION SUMMARY: The Utilization Review Specialist - Behavioral Health works collaboratively with Administration, Coding, Physicians, Nursing, Social Work, ... conditions and treatments from point of entry to discharge. Performs timely utilization and clinical reviews and communicates with insurance/ managed care entities… more
- Elevance Health (Baton Rouge, LA)
- …or related field and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed ... studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article,… more
- Centene Corporation (Raleigh, NC)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... WORK 10 HOURS.** **THIS ROLE WILL MAINLY SUPPORT MEDICARE BEHAVIORAL HEALTH ALL STATES AND DELAWARE MEDICAID...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process… more
- Elevance Health (Cerritos, CA)
- …Experiences:** + 2+ years of experience in a managed care organization in a utilization management behavioral health role preferred. For candidates working ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- Eastern Connecticut Health Network (Manchester, CT)
- …field is required. EXPERIENCE: + Minimum of ten (10) years of experience in the Behavioral Health field with Utilization Review required. + Must have ... POSITION SUMMARY: This position is responsible for maximizing access to inpatient behavioral health care and patient movement for the Department of Behavioral… more
- Adelante (Phoenix, AZ)
- … health issues and providers education to assist with enhancing primary care utilization of behavioral health interventions + Promote a smooth interface ... Behavioral Health Consultant Job Details Job...+ Demonstrate an understanding of facility organizational structure by utilization of appropriate channels of communication. Maintain consistent, timely… more
- Humana (Oklahoma City, OK)
- …part of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific… more
- Spectrum Billing Solutions (Skokie, IL)
- …meetings and case conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or ... for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing team. The...(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. At Spectrum, you… more
- CVS Health (Frankfort, KY)
- …clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... /benefit management function. **Required Qualifications** + **_Kentucky Licensed Independent Behavioral Health Clinician (_** **_LPCC, LCSW, LMFT, LPAT_**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health , Pharmacy, Registered Dietitian ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- AdventHealth (Glendale Heights, IL)
- …you'll need to succeed** + Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able to demonstrate knowledge and skills ... positions + Career Development + Whole Person Wellbeing Resources + Mental Health Resources and Support + Debt-free Education (Certifications and Degrees without… more
- University of Utah Health (Salt Lake City, UT)
- …in outreach initiatives to enhance member understanding of available behavioral health services. + **Technology & System Utilization ** 1. Utilize EPIC (C) ... of Utah Campus and Hospital/Clinics. 2. Ensure timely access to appropriate behavioral health resources, including in-network providers and support services,… more
- UPMC (Pittsburgh, PA)
- …coordination functions through the management of staff and activity which may include behavioral health , utilization management and care management. Serves ... **UPMC Health Plan is looking for a Statewide LTSS Manager to join the Community HealthChoices team!** The LTSS Manager is responsible for the operational functions… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- **Description** Are you skilled in managing behavioral health funding, reimbursements and bed utilization ? Do you excel at fostering a work environment that ... YES to either of these questions, then consider joining our Devereux Advanced Behavioral Health team! **Being a Hospital Director at Devereux Children's … more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...related field or an RN + Two years of behavioral health work experience. + Professional communication… more
- CVS Health (Charleston, WV)
- …the utilization /benefit management function. Required Qualifications: + Licensed independent Behavioral Health clinician or a Registered Nurse (RN) with ... + Managed care/ utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to multitask, prioritize and… more
- Highmark Health (Sacramento, CA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** If located within a 50 mile radius of a Highmark office in PA, DE, WV or NY this is a hybrid role ... deliver engaging and informative product demonstrations and walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization ...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more