- AmeriHealth Caritas (Charleston, SC)
- …us at www.amerihealthcaritas.com . **Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is ... pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services....+ Minimum of 2 years of behavioral health and substance use disorder experience.; + Utilization… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** The Manager, Behavioral Health Utilization Management uses clinical knowledge, communication ... other managers across the department. **_Detailed Responsibilities include:_** Leads Kentucky Medicaid Behavioral Health Utilization Management process… more
- CVS Health (Frankfort, KY)
- …/benefit management program. **Required Qualifications** + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, ... **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a...States. The requirements is for candidates to hold a Behavioral health clinician or Registered Nursing with… more
- Centene Corporation (Jefferson City, MO)
- …appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... including a fresh perspective on workplace flexibility. **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure… more
- Corewell Health (St. Joseph, MI)
- …appropriateness of inpatient admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and ... quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams… more
- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Elevance Health (Los Angeles, CA)
- …care. The **Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... **Manager II Behavioral Health Services** **Location:** This position...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum… more
- CVS Health (Raleigh, NC)
- …schedules will include weekends, holidays, and evening hours._ As a Utilization Management Clinician - Behavioral Health you will utilizes clinical ... and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LMSW, LSW,...Friday with flexible hours between 10:00am to 8:00pm EST. Utilization Management is a 24/7 operation and… more
- CVS Health (Salt Lake City, UT)
- …(MST), Pacific Time (PST), or Arizona time zones. As a ** Utilization Management Clinician Behavioral Health ** you will: - Utilize clinical experience ... management function. **Required Qualifications** - Valid unrestricted independent professional behavioral health clinical license to practice per state… more
- Elevance Health (Seven Fields, PA)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **JR150201 Behavioral Health Clinical Quality Auditor Analyst...is a professional-level clinical (licensed) position that supports risk management functions. The position is primarily responsible for investigating… more
- Elevance Health (Indianapolis, IN)
- …role in a managed care environment and possess strong utilization management experience. + ** Behavioral Health & Chemical Dependency:** Substantial ... Behavioral Health offers superior clinical mental health and substance use disorder management , a...GA, Woodland Hills, CA. **Summary** The Behavioral Health Chief Medical Officer oversees Utilization Review,… more
- Lincoln Financial (Columbus, OH)
- …including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health case management ... **The Role at a Glance** We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization. As a Behavioral … more
- Tufts Medicine (Malden, MA)
- …strategic plan, ensuring integration with Tufts Medicine's overall behavioral health strategy. + Oversee clinical resource management , utilization ... and prescribe medications and treatments. + Assist in the management of behavioral or mental health...You have a strong understanding of behavioral health regulations, quality improvement methodologies, and risk management… more
- UPMC (Jamestown, NY)
- …Registered Nurse. + Minimum of 3 years of experience in behavioral health , clinical care, utilization management , home care, discharge planning, or ... case management . + 5 years of experience in community-based case management and behavioral health _preferred_ . + General knowledge of best practices for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current ... of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist... experience required + 1- 3 years relevant case management / utilization review experience preferred +… more
- Centene Corporation (Columbia, SC)
- …2PM - 4PM TO WORK 10 HOURS.** **THIS ROLE WILL MAINLY SUPPORT MEDICARE BEHAVIORAL HEALTH ALL STATES AND DELAWARE MEDICAID INPATIENT AND PHP PRIOR ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- CVS Health (Baton Rouge, LA)
- …/benefit management function. **Required** **Qualifications** - Licensed independent Behavioral Health clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, ... - Managed care/ utilization review experience preferred Experience in a behavioral health inpatient setting - Ability to multitask, prioritize and… more
- Stanford Health Care (Palo Alto, CA)
- …leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships, ... an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine...preventive care, telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for… more
- Truman Medical Centers (Kansas City, MO)
- …deliver smarter care and better outcomes-apply today to join our Utilization Management team.** **Working at University Health is about making a difference. ... log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity -… more