- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …an experienced utilization review nurse, a sharp case manager, or a behavioral health clinician ready to make an impact behind the scenes, this is your ... floor work-it's clinical leadership with purpose. What You'll Do: Review inpatient, outpatient, and behavioral health...years of clinical experience in ICU, ED, Med-Surg, pediatrics, behavioral health , or similar. Prior Utilization… more
- UHS (Bethlehem, PA)
- Responsibilities Hanover Hill Behavioral Health , located in Bethlehem, Pennsylvania, will combine two leaders in health care, in the partnership of Universal ... late fall 2025. This brand new 144-bed free standing behavioral health facility will offer the community...while working in a state-of-the-art facility, including EPIC. The Utilization Review Director is responsible for overseeing… more
- EvergreenHealth (Kirkland, WA)
- …care teams are composed of the following: Social Workers provide crisis intervention, behavioral health and chemical dependency assessments, screen for abuse and ... provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team… more
- Blue Cross and Blue Shield of Minnesota (Duluth, MN)
- …Have Blue Cross and Blue Shield of Minnesota is hiring a Case Manager on the Behavioral Health , Medicaid team. The Case Manager is a critical component of BCBSMN ... (RN) licensed in the state of Minnesota with psychiatric experience, or a Behavioral Health Professional who is a clinician licensed for independent practice… more
- Kaiser Permanente (Tualatin, OR)
- Description: Job Summary: The Behavioral Health Consultant (BHC) provides expert integrated care to pediatric and adult patients as a member of the Primary Care ... a routine part of primary care. This is a behavioral health model that is interconnected with...chronic medical illnesses), stress-related physical symptoms, ineffective patterns of health care utilization , and adjustment to new… more
- Swope Health (Kansas City, KS)
- As a Behavioral Health Consultant for Swope Health Services Wyandotte Clinic , you will be apart of a team of caregivers that provide care for the people ... that need it the most. As Behavioral Health Consultant(BHC) you will provide brief,...substance abuse; prefer one year in a community mental health setting. Proficient knowledge, utilization , and/or familiarity… more
- UnitedHealth Group (Lexington, KY)
- …global scale. Join us to start Caring. Connecting. Growing together. The goal of the Behavioral Health Advocate is to help individuals live their lives to the ... multiple internal and external partners including consumers and their families/caregivers, medical, behavioral health , and clinical network teams. Behavioral … more
- Duke University (Durham, NC)
- …surgery, women's services, and heart and vascular services. Location: Duke Regional Behavioral Health Center, Durham, North Carolina General Summary Manage a ... care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health ...and Licensure Board. Consult/Liason should also be a Notary. BEHAVIORAL HEALTH CASE MGR Job Level: G2… more
- COMPREHENSIVE HEALTHCARE (Yakima, WA)
- …Day Description Who is Comprehensive Healthcare? Comprehensive Healthcare provides innovative behavioral health and integrated healthcare services to clients of ... working knowledge of insurance authorizations, levels of care, and utilization review . This is a non-clinical role...Professional Two years of clinical experience ina medical or behavioral health setting Working knowledge of current… more
- Molina Healthcare (Long Beach, CA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- A-Line Staffing Solutions (Harrisburg, PA)
- … health , drug and alcohol treatment, managed care, quality management/ utilization review , or equivalent clinical experience. Knowledge of InterQual criteria, ... Job Description A-Line Staffing is now a motivated and detail- oriented Review and Elevation Registered Nurse In Harrisburg, PA Please contact Marcia Hamilton at ###… more
- Rogers Behavioral Health (Oconomowoc, WI)
- …aftercare providers to ensure continuity of care, if warranted. Communicate with the Utilization Review department to provide information necessary to assist in ... managed care companies as needed and coordinate with the utilization review manager or lead. Monitor the...manager/director. Promote department goals and the mission of Rogers Behavioral Health Communicate goals to fellow staff… more
- Baystate Health (Springfield, MA)
- …specialists. Manages transitions of care for patients discharged from the hospital, behavioral health facility/program, emergency room, or from a skilled nursing ... facility. Responsible to review the discharge summaries, follow up on testing that...basis. Develops and collects data to identify trends in utilization of health care resources. Assumes accountability… more
- Baptist Health (Alabaster, AL)
- …a current Alabama RN license. *Handle with Care (HWC) Certification is required for the Behavioral Health Unit within 90 days of hire. The Handle with Care ... Position Summary Join our Growing Team at Baptist Health Shelby Hospital in Alabaster, AL! At Baptist...risk factors and the need for care coordination, clinical utilization management and the transition to the next appropriate… more
- Highmark Health (Erie, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... Company : Allegheny Health Network Job Description : St. Vincent Hospital...engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management… more
- SpringHealth Behavioral Health and Integrated Care (San Antonio, TX)
- Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic Supervisor for Youth ABA Line of Business MUST BE A FULLY LICENSED BCBA ... program development Meet with school districts to provide current information on Spring Health Behavioral Health and Integrated Care Services Explore other… more
- Elevance Health (Waynesville, NC)
- …have access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy, Intellectual/Developmental Disabilities (I/DD) ... to the CFSP Care Management model which includes physical health , behavioral health , and social...may include, but are not limited to: Manages resource utilization to ensure appropriate delivery of care to members,… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our ... a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day… more
- Say Yes Buffalo (Buffalo, NY)
- …tool to determine acuity of care needed. Develop a comprehensive client-centered health assessment inclusive of medical, behavioral and social service needs. ... Family Support Specialist/ Health , with the knowledge of the building Principals,...students and families who are experiencing difficulties with medical/developmental, behavioral , or other social-emotional needs. FSS/H will work with… more
- Mindful Care (Hoboken, NJ)
- …Certified Psychiatric Mental Health Nurse Practitioners (PMHNP) to expand access to behavioral health care in your area. If you're passionate about making a ... difference in mental health and committed to providing exceptional care, we would...$80K annually in productivity incentives (*monthly bonuses, based on utilization metrics). Most clinicians reach a total compensation of… more
