• Manager , Utilization

    Humana (Columbus, OH)
    …and help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Utilization Management ( Behavioral Health) who will utilize ... of behavioral health services and/or benefit administration determinations. The Manager , Utilization Management ( Behavioral Health) applies… more
    Humana (05/09/24)
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  • Utilization Management Case…

    Universal Health Services (Dearborn, MI)
    Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - ... For more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is primarily responsible… more
    Universal Health Services (04/10/24)
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  • RN Utilization Manager - Psychiatric…

    UNC Health Care (Chapel Hill, NC)
    …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed… more
    UNC Health Care (04/13/24)
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  • Utilization Management Plan…

    AmeriHealth Caritas (Newark, DE)
    ** Utilization Management Plan Oversight Manager ** Location: Newark, DE Primary Job Function: Medical Management ID**: 34207 **Job Brief** Qualified ... for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to… more
    AmeriHealth Caritas (05/08/24)
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  • Case Manager with Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
    Beth Israel Lahey Health (04/19/24)
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  • Behavioral Health Quality Assurance…

    Ventura County (Ventura, CA)
    …satisfactory performance, and in accordance with the business needs of the department. Behavioral Health Manager I/II are management classifications and are ... Behavioral Health Quality Assurance Manager Print...management practices; grievances, appeals and notices of actions; behavioral health clinical policies and procedures; utilization more
    Ventura County (04/30/24)
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  • Case Manager - Utilization

    Prime Healthcare (Sherman Oaks, CA)
    …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/161662/ case- manager utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
    Prime Healthcare (05/14/24)
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  • Registered Nurse Case Manager

    Prime Healthcare (Weslaco, TX)
    …#patienttreatmentplan Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156984/registered-nurse-case- manager utilization - management ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
    Prime Healthcare (04/05/24)
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  • Manager , Utilization

    Elevance Health (Washington, DC)
    …degrees of medical complexity and acuity. Participates in case and/or utilization management execution/decision making for managed member populations. Primary ... II HCMS is responsible for managing a team of physical and/or behavioral health practitioners in the development, implementation, and coordination of a comprehensive… more
    Elevance Health (05/02/24)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/157767/case- manager utilization - management ... and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more… more
    Prime Healthcare (04/05/24)
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  • Hospital Reviewer/ Utilization

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... in the State of Florida. + 3 years minimum experience in discharge planning, utilization management , or case management . + Basic proficiency in Microsoft… more
    DOCTORS HEALTHCARE PLANS, INC. (05/14/24)
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  • Behavioral Health Accounting Manager

    Ventura County (Ventura, CA)
    …County strategies. AGENCY/DEPARTMENT: Health Care Agency - Behavioral Health Manager , Accounting I/II are Management classifications and are not eligible ... Behavioral Health Accounting Manager I/II Print..., Accounting II: $4,116.22 - $5,762.71 biweekly DISTINGUISHING CHARACTERISTICS: Manager , Accounting I - is the first management more
    Ventura County (05/09/24)
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  • CCO Behavioral Health Program…

    CareOregon (Medford, OR)
    …+ Knowledge of Behavioral Health managed care practice, including utilization management , population health improvement, guideline development, disease ... Job Title CCO Behavioral Health Program Manager - Adult...Behavioral Health team in the areas of network management and optimization, program development, and delivery system change.… more
    CareOregon (04/16/24)
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  • Clinician I/II, Intensive Case Manager

    UT Health (Houston, TX)
    Clinician I/II, Intensive Case Manager - UTHealth Houston Behavioral Sciences Campus **Location:** Houston, Texas **Hot** **Category:** Clinical Professionals ... UTHealth Houston Behavioral Sciences Campus Requisition #: 2400013W **What we do...evidence-based practice** . Clinical responsibilities will include intensive case management , contributing to treatment planning, participating in utilization more
    UT Health (04/20/24)
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  • Director of Utilization Management

    Universal Health Services (Sacramento, CA)
    …Sierra Vista Hospital is seeking a talented and dynamic Director of Utilization Management to join our team of dedicated healthcare professionals! ... and outpatient chemical dependency services. Position Summary: The Clinical Director of Utilization Management is responsible for the development of best… more
    Universal Health Services (04/18/24)
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  • Behavioral Health Care Manager

    Centene Corporation (Olympia, WA)
    …of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization , case ... Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to… more
    Centene Corporation (05/11/24)
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  • Behavioral Health Equity Services…

    Ventura County (Ventura, CA)
    Behavioral Health Equity Services Manager - Bilingual Required Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4359714) Apply  Behavioral ... Continuous + Description + Benefits + Questions Description Under direction of the Behavioral Health Director, the Equity Services Manager (ESM) promotes and… more
    Ventura County (02/15/24)
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  • Behavioral Health Care Manager

    Centene Corporation (Tallahassee, FL)
    …of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization , case ... Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to… more
    Centene Corporation (04/25/24)
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  • Clinical Case Manager Behavioral

    CVS Health (Tallahassee, FL)
    …standard business hours No nights, weekends, or holidays. As a Clinical Case Manager Behavioral Health you will: -Utilize advanced clinical judgment and critical ... Qualifications - Ability to take and manage crisis calls - Managed care/ utilization review experience - Case management and discharge planning experience… more
    CVS Health (05/03/24)
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  • Senior Utilization Review Consultant (O-5…

    Immigration and Customs Enforcement (IN)
    … Review Consultant will report directly to the IHSC Regional Utilization Manager with the Utilization Management Program Administrator. This is a ... also works jointly with IHSC stakeholders: pharmacy; dental; the Behavioral Health Unit; the Medical Case Management ...directly to the assigned IHSC Regional Utilization Manager (RUM) with the Utilization Management more
    Immigration and Customs Enforcement (05/04/24)
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