• Behavioral Health Utilization

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... on department activities as assigned. Essential Skills + Experience in utilization management, behavioral health , and mental health . + Proficiency… more
    Actalent (10/04/25)
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  • Senior Manager, Behavioral Health

    Centene Corporation (Phoenix, AZ)
    …person meetings at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure ... and facilitates operations within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with… more
    Centene Corporation (09/14/25)
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  • Behavioral Health Utilization

    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. ... + Must reside in Kentucky or bordering Counties + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT,… more
    CVS Health (09/13/25)
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  • Utilization Management - Behavioral

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
    Humana (09/27/25)
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  • Behavioral Health Consultant-RN…

    WellSpan Health (York, PA)
    …to Behavioral Health . Performs a variety of reviews and applies Behavioral Health utilization and consultative services to determine the most ... efficient use of resources to support the behavioral health care goal of appropriate, cost...needs. + Assists with the collection and analysis of utilization patterns. + Brings known or suspected problems of… more
    WellSpan Health (09/05/25)
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  • Manager Behavioral Health Services

    Elevance Health (Columbus, OH)
    **JR167272 Manager Behavioral Health Services** Responsible for overseeing Behavioral Health Utilization Management (BH UM), this position supports ... appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination,...UM: MS in social work, counseling, psychology or related behavioral health field or a degree in… more
    Elevance Health (09/30/25)
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  • Transitional Care Manager, Behavioral

    CVS Health (Oklahoma City, OK)
    …to identify and address patient needs (eg care team, social work, behavioral health , utilization management, Hard-to-Reach, Central Telehealth, etc.). ... assurance activities. **What are we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing within the state of… more
    CVS Health (09/17/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Rochester, NY)
    …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
    Molina Healthcare (10/03/25)
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  • ABA Utilization Review (UR) Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …Strong computer skills (Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist ​#UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
    Spectrum Billing Solutions (09/01/25)
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  • Utilization Review Specialist

    Devereux Advanced Behavioral Health (Malvern, PA)
    …motivated professionals? If you answered YES, then consider joining our Devereux Advanced Behavioral Health team! Being a Utilization Review Specialist at ... your passion for helping individuals in need. Devereux's Children Behavioral Health Center (DCBHC) is currently seeking a Utilization Review Specialist to… more
    Devereux Advanced Behavioral Health (09/26/25)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …WITH POTENTIAL FOR WEEKEND AND HOLIDAY ROTATIONS**'** MUST HOLD NORTH CAROLINA BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and ... regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process… more
    Centene Corporation (09/25/25)
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  • Manager, Healthcare Services; Utilization

    Molina Healthcare (GA)
    …professionals in some or all of the following functions: care management, utilization management, behavioral health , care transitions, long-term services ... the following areas: utilization management, care management, care transitions, behavioral health , long-term services and supports (LTSS), or equivalent… more
    Molina Healthcare (09/19/25)
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  • Utilization Management Nurse…

    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 ... o Appropriately documents all relevant communications in EPIC. + Ensures appropriate utilization of observation and inpatient status from admission to discharge. o… more
    Omaha Children's Hospital (09/05/25)
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  • Behavioral Health Consultant

    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
    Adelante (09/24/25)
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  • Nurse Supervisor, Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    …professionals in some or all of the following functions: care management, utilization management, behavioral health , care transitions, long-term services ... * Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with… more
    Molina Healthcare (09/25/25)
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  • Chief Psychiatrist - Behavioral

    Humana (Springfield, IL)
    …administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and ... health first** The Chief Psychiatrist oversees our behavioral health (BH) clinical program for our...Quality Management (QM) program; and work closely with the Utilization Management (UM) of services and associated appeals related… more
    Humana (08/29/25)
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  • Nurse Manager Behavioral Health

    HCA Healthcare (Dulles, VA)
    …Hospital Center! **Manages the day-to-day operations of the Behavioral Health Nursing Department through effective utilization of self, shift House ... **Introduction** Do you have the career opportunities as a Nurse Manager Behavioral Health you want in your current role? We invest in what matters… more
    HCA Healthcare (08/10/25)
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  • UM - Applied Behavioral Analysis

    Humana (Tallahassee, FL)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional work… more
    Humana (10/02/25)
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  • Mobile Professional Care Manager (Hybrid)

    UPMC (Jamestown, NY)
    …or a licensed Registered Nurse. + Minimum of 3 years of experience in behavioral health , clinical care, utilization management, home care, discharge ... across the healthcare continuum, working with physicians, case managers, pharmacy, and behavioral health providers. + Provide expert referrals and connect… more
    UPMC (08/30/25)
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  • Case Manager, RN or Licensed Behavioral

    Excellus BlueCross BlueShield (Dewitt, 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
    Excellus BlueCross BlueShield (09/30/25)
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