- APN Consulting, Inc (VA)
- …collaboration to enhance the continuity of care for Client members including Behavioral Health and Long Term CareMaintains department productivity and quality ... time zone requirements? No, EST preferred What are the must have requirements? UM experience What are the day to day responsibilities? Review provider requests for… more
- Kepro (Richmond, VA)
- …being a vital partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer RN to join our growing team. ... are now Acentra Health ! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to… more
- Molina Healthcare (Bronx, NY)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... of service. **We are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review Clinician...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
- Elevance Health (Louisville, KY)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Atlanta, GA)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Rancho Cordova, CA)
- …The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- CVS Health (Richmond, VA)
- …provide education and training + Consults with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical ... services system issues + Supports and encourages CM and UM staff to function as interdisciplinary team, with requisite...with delivery/ supervision of community-based Medicaid behavioral health services required + 5+ years clinical … more
- LA Care Health Plan (Los Angeles, CA)
- …activities to improve overall compliance with all regulations and standards. Clinical Auditor ( Behavioral Health ): In addition to ... the duties above, the Clinical Auditor ( Behavioral Health ) will design an audit program... Health units, the Medical Director of Behavioral Health , attendance at UM … more
- Elevance Health (Colorado Springs, CO)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health … more
- Universal Health Services (Highlands Ranch, CO)
- Responsibilities Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in Littleton, CO. Highlands features individual units ... ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access… more
- One Health (Miles City, MT)
- …with on the job training perfect for someone wanting to move into the world of behavioral health but doesn't know where to start. One Health offers great ... SUMMARY: Functions as a core member of an integrated behavioral health team that may involve the...and follow-up c + T racks patient follow-up and clinical outcome + Documents encounters in the EHR per… more
- Elevance Health (Woburn, MA)
- …necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers ... Health PulsePoint locations._ Must have a current, unrestricted Clinical License in the state of Massachusetts as an...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- CVS Health (Sacramento, CA)
- …hours. No nights, weekends or holidays. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in a collaborative process ... with clients with an Autism Diagnosis - Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
- Elevance Health (Costa Mesa, CA)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Outreaches to providers as necessary for ... Behavioral Care Manager** **II** is responsible for completing clinical assessments, screenings, and managing crisis calls in a...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (New York, NY)
- …locations. **Hours:** Monday-Friday 8:00 am -5:30 pm Eastern Standard Time The Behavioral Health Care Manager II is responsible for managing psychiatric ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management and ... health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. ** Based in New Mexico… more
- UNC Health Care (Chapel Hill, NC)
- …organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Utilization Manager Psych ... Team completes clinical reviews for all areas: Inpatient, Observation for Psych...and YBH. The team assists the weekends and other UM teams with their reviews. Schedule: Fulltime: Day Shift… more
- CVS Health (Richmond, VA)
- …Greensville, Nottoway. Up to 25% of expected travel. Standard business hours: Monday-Friday. The Behavioral Health Clinical Liaison is a clinical leader ... - Consults with Plan executive management regarding physical and behavioral health clinical issues as...clinical issues as they relate to medical management ( UM , CM, DM) provider and system of care issues,… more
- Centene Corporation (Austin, TX)
- …assigned + Complies with all policies and standards **Education/Experience:** Master's degree in behavioral health and an unrestricted license as a LCSW, LMFT or ... changes everything for our 28 million members as a clinical professional on our Medical Management/ Health Services...achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members'… more
- LA Care Health Plan (Los Angeles, CA)
- …Management ( UM ), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health , Community Health , Health Education, as well ... Enhanced Care Management Clinical Specialist II Job Category: Clinical ...analyze the most complex cases involving highly acute physical health , behavioral health , complex/catastrophic and/or… more
