• Utilization Management

    Humana (Columbus, OH)
    …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (04/09/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinician…

    CVS Health (Salt Lake City, UT)
    …(MST), Pacific Time (PST), or Arizona time zones. As a ** Utilization Management Clinician Behavioral Health ** you will: - Utilize clinical experience ... management function. **Required Qualifications** - Valid unrestricted independent professional behavioral health clinical license to practice per state… more
    CVS Health (04/17/25)
    - Save Job - Related Jobs - Block Source
  • Manager, Utilization Management

    Humana (Frankfort, KY)
    …of our caring community and help us put health first** The Manager, Behavioral Health Utilization Management uses clinical knowledge, communication ... other managers across the department. **_Detailed Responsibilities include:_** Leads Kentucky Medicaid Behavioral Health Utilization Management process… more
    Humana (04/26/25)
    - Save Job - Related Jobs - Block Source
  • Supervisor, Behavioral Health

    Centene Corporation (Phoenix, AZ)
    …appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... Arizona for this remote position.** **Position Purpose:** Supervises the behavioral health (BH) utilization review...performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH… more
    Centene Corporation (04/09/25)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Utilization

    AmeriHealth Caritas (Charleston, SC)
    …us at www.amerihealthcaritas.com . **Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is ... pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services....+ Minimum of 2 years of behavioral health and substance use disorder experience.; + Utilization more
    AmeriHealth Caritas (03/18/25)
    - Save Job - Related Jobs - Block Source
  • Chief Medical Officer- Psychiatrist, Carelon-…

    Elevance Health (Indianapolis, IN)
    …role in a managed care environment and possess strong utilization management experience. + ** Behavioral Health & Chemical Dependency:** Substantial ... Behavioral Health offers superior clinical mental health and substance use disorder management , a...GA, Woodland Hills, CA. **Summary** The Behavioral Health Chief Medical Officer oversees Utilization Review,… more
    Elevance Health (04/29/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager I/II/III, RN ( Behavioral

    Excellus BlueCross BlueShield (Rochester, NY)
    …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
    Excellus BlueCross BlueShield (04/19/25)
    - Save Job - Related Jobs - Block Source
  • Manager II Behavioral Health

    Elevance Health (Los Angeles, CA)
    …care. The **Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Manager II Behavioral Health Services** **Location:** This position...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum… more
    Elevance Health (04/16/25)
    - Save Job - Related Jobs - Block Source
  • Manager Behavioral Health Services

    Elevance Health (Houston, TX)
    …Prairie, TX The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Manager Behavioral Health Services** The ideal candidate...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
    Elevance Health (04/17/25)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health

    CVS Health (Frankfort, KY)
    …/benefit management program. **Required Qualifications** + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, ... **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a...States. The requirements is for candidates to hold a Behavioral health clinician or Registered Nursing with… more
    CVS Health (04/05/25)
    - Save Job - Related Jobs - Block Source
  • RN Behavioral Health Admissions…

    Corewell Health (St. Joseph, MI)
    …appropriateness of inpatient admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and ... quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams… more
    Corewell Health (04/19/25)
    - Save Job - Related Jobs - Block Source
  • Chief Medical Officer, Health Plans

    VNS Health (Manhattan, NY)
    …effective quality care is being provided as needed. + Reviews utilization , care management and behavioral health (BH) data; identifies trends and needs ... guidance to the daily operations and administration of medical management for VNS Health Plans. Assists senior...cases. Participates in the QARR/HEDIS Quality Improvement Activities and utilization management of the population. Works under… more
    VNS Health (02/19/25)
    - Save Job - Related Jobs - Block Source
  • CM Delegation Liaison

    Molina Healthcare (Columbus, OH)
    …**REQUIRED QUALIFICATIONS:** + At least 3 years' health care experience in care management , utilization management , behavioral health , medical, ... an integrated delivery of care across the continuum, including behavioral health and long term care, for...as needed. + Assists in preparation of documents for utilization management , care management , state,… more
    Molina Healthcare (04/09/25)
    - Save Job - Related Jobs - Block Source
  • Consultant, Behavioral Health

    Lincoln Financial (Columbus, OH)
    …including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health case management ... **The Role at a Glance** We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization. As a Behavioral more
    Lincoln Financial (04/17/25)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Utilization

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you want to join an organization that invests in you as a Behavioral Health Utilization Review Specialist? At Parallon, you come first. ... make a difference. We are looking for a dedicated Behavioral Health Utilization Review Specialist...health experience required + 1-3 years relevant case management / utilization review experience preferred +… more
    HCA Healthcare (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Utilization

    HCA Healthcare (Nashville, TN)
    **Description** **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current ... of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist... experience required + 1- 3 years relevant case management / utilization review experience preferred +… more
    HCA Healthcare (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Clinician…

    Centene Corporation (Madison, WI)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
    Centene Corporation (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinical…

    CVS Health (Baton Rouge, LA)
    …/benefit management function. **Required** **Qualifications** - Licensed independent Behavioral Health clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, ... - Managed care/ utilization review experience preferred Experience in a behavioral health inpatient setting - Ability to multitask, prioritize and… more
    CVS Health (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Manager, Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships, ... an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine...preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for… more
    Stanford Health Care (02/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management RN Hourly…

    Truman Medical Centers (Kansas City, MO)
    …deliver smarter care and better outcomes-apply today to join our Utilization Management team.** **Working at University Health is about making a difference. ... log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity -… more
    Truman Medical Centers (04/16/25)
    - Save Job - Related Jobs - Block Source