- 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 (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
- 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
- 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
- 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
- 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)
- …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
- 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
- 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
- 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
- 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
- Monte Nido (Miami, FL)
- …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been ... within an intimate home setting. We are seeking a Utilization Review Clinician to join our team...+ Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and… more
- Centene Corporation (Atlanta, GA)
- …degree for behavioral health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- BriteLife Recovery (Englewood, NJ)
- …in utilization review , case management, or insurance coordination in a behavioral health or substance use treatment setting. + Knowledge of ASAM criteria ... What you will be doing? The Utilization Review (UR) Specialist is a...and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? +… more
- State of Indiana (Evansville, IN)
- Utilization Review Coordinator-LPN Date Posted: Oct 1, 2025 Requisition ID: 466513 Location: Evansville, IN, US, 47714 Work for Indiana Begin a fulfilling career ... a Psychiatric Medicare/Medicaid Hospital. Role Overview: This position serves as the Utilization Review Coordinator within a psychiatric hospital setting. They… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... collective bargaining agreement, seniority, etc. Responsible for identifying potential behavioral health inpatient unit candidates, pre-screening referrals, and… 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
- Molina Healthcare (Las Vegas, NV)
- …to applied behavioral analysis (ABA) services. Responsible for verifying that behavioral health services are medically necessary and align with established ... with the utilization and care management departments to provide ABA and behavioral health therapy (BHT) services to Molina members with autism spectrum… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more