- Kepro (Richmond, VA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (PRN, Remote within Virginia) with ... active RN, LCSW, LPC, and/or LBA to join our growing team. Job Summary: Our Behavioral Health UM Clinical Reviewer (RN, LCSW,LPC, and/or LBA) will use … more
- CVS Health (Sacramento, CA)
- …hours. No nights, weekends or holidays. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in a collaborative process ... with clients with an Autism Diagnosis - Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
- Universal Health Services (Oakland Park, FL)
- …maintenance of high quality patient care through the analysis, review and evaluation of clinical practices within the Behavioral Health Center. Other duties ... Responsibilities Fort Lauderdale Behavioral Health Center, a subsidiary of...Experience: + A minimum of two (2) years direct clinical experience in a psychiatric or mental health… more
- 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
- Molina Healthcare (Bronx, NY)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... illness and the site of service. **This position will support our Senior Whole Health business.** **_Senior Whole Health by Molina_** **is a Managed Long-Term… more
- Elevance Health (Los Angeles, 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
- Molina Healthcare (Bronx, NY)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... of service. **We are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review Clinician...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
- Molina Healthcare (Bronx, NY)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... service. **We are seeking a Registered Nurse with previous UM and** **inpatient experience along with knowledge of the...and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Care for Molina… more
- Healthfirst (NY)
- …specific clinical team (such as Care Management, Utilization Management, Behavioral Health , etc.) and may have additional departmental responsibilities. ... outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf… more
- LA Care Health Plan (Los Angeles, CA)
- …activities to improve overall compliance with all regulations and standards. Clinical Auditor ( Behavioral Health ): In addition to ... the duties above, the Clinical Auditor ( Behavioral Health ) will design an audit program... Health units, the Medical Director of Behavioral Health , attendance at UM … more
- Humana (Richmond, VA)
- …search of a Behavioral Health Medical Director who will oversee our behavioral health (BH) clinical program for Medicaid members in Virginia. They ... UM ), Quality Improvement, and value‐based payment programs. The Behavioral Health Director will be based in...go-live date.** + Minimum five (5) years or more clinical experience working in behavioral health… more
- Elevance Health (Las Vegas, NV)
- … family of companies, **Carelon Behavioral Health ** , formerly Beacon Health Options, offers superior clinical mental health and substance use ... you for payment as part of consideration for employment. ** Behavioral Health Care Manager II** + Job...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers… more
- One Health (Sheridan, WY)
- P OSITION SUMMARY: Functions as a core member of an integrated behavioral health team that may involve the patient's primary care provider in a clinic and/or ... state and federal confidentiality requirements. Works under the direction of licensed behavioral health and/or medical providers, is responsible for coordinating… more
- One Health (Hardin, MT)
- …with on the job training perfect for someone wanting to move into the world of behavioral health but doesn't know where to start. One Health offers great ... SUMMARY: Functions as a core member of an integrated behavioral health team that may involve the...and follow-up c + T racks patient follow-up and clinical outcome + Documents encounters in the EHR per… more
- Humana (Columbus, OH)
- …Behavioral Health Facilities to obtain sufficient clinical information. The UM Behavioral Health RN work assignments are varied and frequently ... of clinical and Utilization Management experience. The Utilization Management Behavioral Health Nurse completes medical record reviews from medical records… more
- Tri-County Mental Health Services (Kansas City, MO)
- Quality Assurance Specialist in Behavioral Health Summary **Title:** Quality Assurance Specialist in Behavioral Health **ID:** 3100 **Department:** ... **Employment Status:** Full-time Description **POSITION SUMMARY** Responsible for conducting clinical and billing audits, along with reviewing monitoring reports.… more
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management and ... health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. ** Based in New Mexico… more
- UNC Health Care (Chapel Hill, NC)
- …organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Utilization Manager Psych ... Team completes clinical reviews for all areas: Inpatient, Observation for Psych...and YBH. The team assists the weekends and other UM teams with their reviews. Schedule: Fulltime: Day Shift… more
- WellSense (Boston, MA)
- …direction of the Vice President of the Senior Vice President of Behavioral Health , the Senior Director of BH Clinical Programs oversees the BH Care ... (customer service, marketing, sales, product, finance, utilization management, pharmacy, behavioral health ) and external stakeholders to ensure operational… more
- LA Care Health Plan (Los Angeles, CA)
- …Management ( UM ), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health , Community Health , Health Education, as well ... Enhanced Care Management Clinical Specialist II (RN or LCSW) Job Category:...analyze the most complex cases involving highly acute physical health , behavioral health , complex/catastrophic and/or… more