- Merck & Co. (North Wales, PA)
- …interacting with multiple channels to access drug, medical and practice management information as needed, real-time. To enhance our Company Oncology's Go-To-Market ... and third-party digital partnership choices aligned to strategic-priorities and behavioral /communication objectives to drive business impact Design Customer Engagement… more
- Humana (Columbus, OH)
- …Influences and assists corporate leadership in strategic planning to improve effectiveness of behavioral health utilization management programs. + ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health ) who will utilize their clinical… more
- Banner Health (AZ)
- …and in an interdisciplinary team format. PREFERRED QUALIFICATIONS Previous experience with behavioral health utilization management . Additional related ... by offering remote and hybrid work settings. As a Behavioral Health Utilization Care Manager,...continuum of care. 6. Educates internal members of the health care team on case management and… more
- Centene Corporation (Jefferson City, MO)
- …Licensure and/or Compact State Licensure required Additional Details: * Department: IL Meridian Behavioral Health Utilization Management Pay Range: ... CST or EST time zone with experience in mental health settings and utilization management ...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- 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… more
- Elevance Health (Cerritos, CA)
- …training, or as otherwise required by managers. **Shift:** **M-F; 8:30am-5:00pm** Responsible for Behavioral Health Utilization Management (BH UM), or ... Behavioral Health Case Management (BH CM) or a combination of both functions...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum… more
- Kepro (Richmond, VA)
- …Health UM Clinical Reviewer (part-time) to join our growing team. Job Summary: Our Behavioral Health Utilization Management Clinical Reviewer will use ... CNSI and Kepro are now Acentra Health ! Acentra Health exists to empower...assessment and critical thinking skills. + 1+ year of Utilization Review (UR) and/or Prior Authorization or related work… more
- Universal Health Services (Philadelphia, PA)
- …to join our team. Utilization Management (UM) Coordinator Position Fairmount Behavioral Health System is seeking a Utilization Management (UM) ... Responsibilities Located on a 27-acre wooded campus, Fairmount Behavioral Health System is a peaceful,...is one of the nation's largest and most respected health care management companies operating through its… more
- Elevance Health (Atlanta, GA)
- …and improvement work; LEAN or Continuous Quality Improvement skills and/or behavioral health , risk management , and/or utilization review in a managed ... **JR110688 Behavioral Health Clinical Quality Audit Analyst...to join our team in Georgia within the Quality Management (QM) Department. The Quality Assessor will be responsible… more
- CVS Health (Austin, TX)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... or substance abuse setting required + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
- CVS Health (Sandy, UT)
- … utilization /benefit management function. Required Qualifications + 3+ years of behavioral health clinical experience in a hospital setting + Must have ... clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
- CVS Health (Sacramento, CA)
- …Monday-Friday standard business hours. No nights, weekends or holidays. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in ... with clients with an Autism Diagnosis - Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
- CVS Health (Richmond, VA)
- …of care, and appropriate discharge planning. + Serve as the behavioral health subject matter expert to support care management staff in serving Aetna ... (MCO). + Experience with supervision of community-based Medicaid behavioral health services. + Experience in completing utilization management … more
- CareOregon (Medford, OR)
- …Knowledge of Behavioral Health managed care practice, including utilization management , population health improvement, guideline development, disease ... crisis systems, criminal justice, and law enforcement, and CareOregon's Behavioral Health team in the areas of network management and optimization, program… more
- Kepro (Charleston, WV)
- …+ Ability to operate as a subject matter expert related to medical and behavioral health utilization management operations while driving operational ... including Utilization Management , and Case Management functions for Medical and Behavioral Health Services. This pivotal role encompasses a… more
- Humana (Indianapolis, IN)
- …integrate the day-to-day administration and strategic management of physical and behavioral health services, including utilization management (UM), ... focusing on quality management , utilization management , discharge planning and/or home health or...or BH leadership experience + Experience in palliative care, behavioral health , or adult medicine. **Scheduled Weekly… more
- Universal Health Services (Sacramento, CA)
- …mental health , or a related field or RN with prior Utilization Management and Behavioral Health experience. Experience: A minimum of one (1) year ... Department. If you're passionate about working in the behavioral health setting and have the desire...from emotional, behavioral and addiction problems. The Utilization Management Coordinator (MSW, MFT, MA, RN)… more
- G-TECH Services, Inc. (Detroit, MI)
- … care related health insurance experience, ideally within behavioral health or utilization management Education/Certifications - Include: * High ... Engagement Description - Supports operational activities for a behavioral health program through summarizing data trends, maintaining business processes,… more
- Centene Corporation (TX)
- …of case and/or utilization management experience. Experience in psychiatric health care settings, child behavioral health conditions and members with ... functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge… more
- Centene Corporation (Tallahassee, FL)
- …of case and/or utilization management experience. Experience in psychiatric health care settings, child behavioral health conditions and members with ... functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge… more
