• Detroit Medical Center (Detroit, MI)
    …Qualifications BSN preferred. At least two (2) years acute hospital or Behavioral Health patient care experience required. One (1) year hospital ... duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and resources in advocating for...acute or behavioral health case management experience preferred. Active… more
    JobGet (06/17/24)
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  • UM Clinician Behavioral

    CVS Health (Salt Lake City, UT)
    …Time (PST), or Arizona time zones. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in a collaborative process to ... utilization/benefit management function. Required Qualifications - Valid unrestricted independent professional behavioral health clinical license to practice… more
    CVS Health (06/05/24)
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  • Auditor, Clinical Services - UM

    Molina Healthcare (Dallas, TX)
    …management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical auditing/review experience. To all ... + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case...UM ), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors… more
    Molina Healthcare (06/10/24)
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  • UM Coordinator - Full-time - Days

    Universal Health Services (Memphis, TN)
    Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate ... paid time off. Since 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and Mid-South… more
    Universal Health Services (05/17/24)
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  • Utilization Management ( UM ) Program…

    Community Based Care of Brevard, Inc. (Osceola County, FL)
    …position evaluates the efficiency, appropriateness, and clinical necessity of mental health , behavioral health and substance abuse treatment services ... Salary: $67,000/year Position Summary: The UM Program Manager provides oversight and management of...of the service authorization process and supports Children's Mental Health funding through (100/806) referrals from the Clinical more
    Community Based Care of Brevard, Inc. (06/18/24)
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  • Medical Director, UM Review, Family…

    AmeriHealth Caritas (Orlando, FL)
    …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... of business within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your...Excellence in the identification and analysis of medical and behavioral health information in order to develop… more
    AmeriHealth Caritas (06/11/24)
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  • UM Medical Director - Orthopedic Surgery

    Elevance Health (Louisville, KY)
    …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (05/10/24)
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  • UM Medical Director

    Elevance Health (Atlanta, GA)
    …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (05/08/24)
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  • UM Medical Director - Pediatrician…

    Elevance Health (Rancho Cordova, CA)
    …The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (05/03/24)
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  • Mgr II Behavioral Health Svcs

    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 ... of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. +...clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. + Additional… more
    Elevance Health (05/23/24)
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  • Manager Clinical Behavioral

    Corewell Health (Grand Rapids, MI)
    … Manager provides clinical and operational management over all behavioral health programming and services delivered to the organization's membership ... objectives. + Plan and direct all Quality, UM and Clinical regulatory functions of the Behavioral Health department in order to maintain regulatory and… more
    Corewell Health (06/01/24)
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  • Behavioral Health Care Manager II

    Elevance Health (Rocky Hill, CT)
    ** Behavioral Health Care Manager II** **This...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers ... - Friday 8:30 am to 5 pm EST.** The Behavioral Health Care Manager II is responsible...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health more
    Elevance Health (06/06/24)
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  • Behavioral Health Care Manager II

    Elevance Health (Rocky Hill, CT)
    …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health more
    Elevance Health (05/16/24)
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  • Medicare Behavioral Health

    CVS Health (Tallahassee, FL)
    …experience with these services . Must have active and unrestricted independent Master's level Behavioral Health clinical license in the state of residence ... Hours for this role are Monday-Friday 8:30a-5:00p EST. Position Summary The Medicare Behavioral Health Outpatient clinician will be part of the Medicare… more
    CVS Health (06/12/24)
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  • Behavioral Health Senior Clinician…

    Fairfax County Sheriff's Office (Fairfax, VA)
    Behavioral Health Senior Clinician - Residential Treatment & Detox Services Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4537593) ... Apply  Behavioral Health Senior Clinician - Residential Treatment...health in one of the following areas: Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Clinical more
    Fairfax County Sheriff's Office (06/17/24)
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  • Behavioral Health Care Manager II

    Elevance Health (Rocky Hill, CT)
    Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental health and substance use ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
    Elevance Health (06/08/24)
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  • Behavioral Health Care Manager II

    Elevance Health (Palo Alto, CA)
    …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Outreaches to providers as necessary for ... Behavioral Care Manager** **II** is responsible for completing clinical assessments, screenings, and managing crisis calls in a...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
    Elevance Health (06/12/24)
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  • Behavioral Health Care Manager I…

    Elevance Health (Indianapolis, IN)
    …the hired candidate may be asked to work in office as needed.** The ** Behavioral Health Care Manager I** - **Indiana** is responsible for managing psychiatric ... healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
    Elevance Health (05/23/24)
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  • Senior Care Manager, Telephonic Behavioral

    Humana (Columbus, OH)
    …and receives guidance where needed. Follows established guidelines / procedures, utilizes behavioral health knowledge and skills to support the coordination, ... part of our caring community and help us put health first** This is a non-exempt position with responsibility...and every six-month reauthorization thereafter. Associate will utilize specified UM tools to assist in guiding clinical more
    Humana (06/13/24)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Albuquerque, NM)
    **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
    Molina Healthcare (05/30/24)
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