- Centene Corporation (San Antonio, TX)
- …related to mental health and substance abuse is preferred. + Utilization Review / Utilization management with behavioral health cases + Precertification, ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
- Molina Healthcare (Austin, TX)
- …in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- Molina Healthcare (San Antonio, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
- Molina Healthcare (Austin, TX)
- **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
- HCA Healthcare (Frisco, TX)
- …interdisciplinary team members, payer representatives, and other parties as appropriate regarding behavioral services + Performs utilization review as ... hours volunteering in our communities. As a(an) Licensed Intake Clinician PRN with Medical City Mental Health and Wellness...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- CenterWell (Austin, TX)
- …consistent and standardized program workflows, dyad communication/partnership, and quarterly business review of acute care and post-acute care utilization . + ... and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with...credible leader with deep understanding and empathy for the clinician and patient pain points in day-to-day panel management… more
- CVS Health (Austin, TX)
- …Spanish speaking **Education** Bachelor's of Science degree or non licensed master level clinician required, with either degree being in behavioral health or ... Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies.… more
- BrightSpring Health Services (San Antonio, TX)
- …+ In-service behavior clinician (s) on all changes made to regulations. + Review all billing for BCBAs, BCaBA's, RBTs and Behavior Technicians on a minimum the ... Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic...professional teams. Provide staff/family training on implemented programs. + Review all Functional Behavior Assessments/Behavior Support Plans prior to… more