- Centene Corporation (New York, NY)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
- Educational Alliance, Inc. (New York, NY)
- …active participation on the Performance Improvement Committee + Monitor and support Utilization Review and authorizations for treatment to ensure current ... clinical insight and expertise + Facilitate the integration of behavioral , clinical and ancillary counseling staff in the part...of up to 10 cases in absence of a clinician + Provide clients with individual and group counseling… more