- Centene Corporation (Madison, WI)
- …appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... anywhere in the United States **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
- CVS Health (Denver, CO)
- …care setting such as ambulatory care or outpatient clinic/facility. * Unencumbered Independent Behavioral Health clinical license in the state where they work. ... LMSW, LSW, LISW, LMFT, LMHC, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** * Knowledge of mental … more
- CVS Health (Harrisburg, PA)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health . Utilizes clinical experience and skills in a ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...+ Must have active current and unrestricted Independent clinical behavioral health license in the state of… more
- CVS Health (Austin, TX)
- …meetings when requested. - Oversight and implementation of the utilization management program for behavioral health services, including monitoring for ... and is responsible for * Leadership and counsel for utilization management * Leadership and participation in...development of clinical practice standards, policies, and procedures. - Behavioral health care management performance… more
- CVS Health (Baton Rouge, LA)
- …meetings when requested. * Oversight and implementation of the utilization management program for behavioral health services, including monitoring for ... in the development of clinical practice standards, policies, and procedures. * Behavioral health care management performance and coordination with… more
- Elevance Health (Olathe, KS)
- …care managers (UM).** The **Manager of Behavioral Health ** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Position specific details: We are currently hiring three Managers of Behavioral Health for our partnership with KanCare. Two will be responsible for overseeing… more
- Spokane County (Spokane, WA)
- …for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health . + Knowledge of federal ... behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health ...Coordinator: + Performs utilization management , utilization review, or concurrent review of behavioral … more
- Point32Health (MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Provide behavioral health utilization review and care management in order ... care and to ensure coordination of care. To facilitate coordination and integration of behavioral health , medical management , and case management … 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
- CVS Health (Tallahassee, FL)
- …working in community based mental health service like Targeted Care Management , Psychosocial Rehabilitation, or related utilization management experience ... 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
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- BronxCare Health System (Bronx, NY)
- Overview The Coordinator- Behavioral Health Utilization Management (BH-UMC) will review and monitor all patientsadmitted into psychiatry or substance ... for appropriateness of admission according to nationally recognizedcriteria. Responsibilities The Coordinator- Behavioral Health Utilization Management … more
- Kepro (Indianapolis, IN)
- … Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical ... the public sector. Acentra is looking for a Part-Time Behavioral Health Medical Director to join our...clinical specialty if MD or DO. + Experience in Utilization Management (UM) with knowledge of Medicaid… more
- VNS Health (Manhattan, NY)
- …implementation of the behavioral health sections of the Quality Management (QM)/ Utilization Management (UM) Plan. Oversees the administration of all ... Develops, implements, monitors and evaluates Utilization and Care Management metrics specific to Behavioral health services across all plan types as… more
- Centene Corporation (Tallahassee, FL)
- …/ Behavioral health . 5+ years of experience in managed care, utilization management , case management , or quality improvement **For Behavioral ... liaison on utilization , quality improvement and case management activities + For NH Health Plan...with a Florida license and experience in an outpatient behavioral health setting, experience working in provider… more
- UNC Health Care (Smithfield, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- CareFirst (Washington, DC)
- …for issues related to Medicare/Medicare Advantage, prescription drugs, utilization management , and behavioral health . **ESSENTIAL FUNCTIONS:** The ... by AHIP, the Blue Cross and Blue Shield Association (BCBSA), the Association for Behavioral Health and Wellness (ABHW), and others as needed. + In support… more
- Intermountain Health (Murray, UT)
- …innovative management of Select Health 's Health Services care management and utilization management programs. Programs include but are not ... Description:** The Healthy Connections (Care Management and Utilization Review) AVP at Select Health oversees...limited to acute, complex medical and social, behavioral health and care coordination programs across… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the ... for preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices.… more
- CVS Health (Baton Rouge, LA)
- …/benefit management function. **Required** **Qualifications** + Licensed independent Behavioral Health clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to… more