- Centene Corporation (Springfield, IL)
- …experience in various mental health settings especially inpatient behavioral health units, utilization management / review , and youth or pediatric ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- UNC Health Care (Hendersonville, NC)
- …for behavioral health services. Working closely with behavioral health clinicians, utilization review , case management, and finance teams, the ... This role involves the review , coordination, and tracking of behavioral health referrals, ensures adherence to safety protocols, age-appropriate clinical… more
- Spectrum Billing Solutions (Skokie, IL)
- …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- CVS Health (Austin, TX)
- …not accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review ... At CVS Health , we're building a world of health...Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation… more
- CVS Health (Austin, TX)
- …not accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review ... At CVS Health , we're building a world of health...with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- CVS Health (Harrisburg, PA)
- …. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health clinical experience ... day. **Position Summary-** + **Master's Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and...years BH clinical Experience** + **1 or more years Utilization Management Experience** + **Work at Home role. Can… more
- Humana (Little Rock, AR)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Elevance Health (CA)
- ** Behavioral Health Care Manager I, Utilization Management** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... an accommodation is granted as required by law. The ** Behavioral Health Care Manager I, Utilization...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review .… more
- CVS Health (Phoenix, AZ)
- …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
- Devereux Advanced Behavioral Health (Viera, FL)
- **Description** Are you looking to advance your career in Admissions & Utilization Review ? If you answered yes, then consider joining our team where you can take ... your career to the next level. **Being the Utilization Review Coordinator at Devereux has its...Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide… more
- UnityPoint Health (Cedar Rapids, IA)
- …site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management -...preferred. At least two (2) years acute hospital or Behavioral Health patient care experience required. One ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...(1) year hospital acute or behavioral health case management experience preferred. Active… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Behavioral Health Institute is a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. ... access the full range of their benefits through the utilization review process. Requirements + Education: Master's...Luck & we hope to meet you soon! Georgetown Behavioral Health Institute is an equal opportunity… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …** Utilization Management Coordinator** utilizes clinical knowledge and understanding of behavioral health resource management to review and coordinate ... a case by case basis. Applies case management and utilization review principles in monitoring the delivery...+ Minimum five years of clinical experience in a behavioral health care setting. + Excellent written… more
- BriteLife Recovery (Englewood, NJ)
- …in utilization review , case management, or insurance coordination in a behavioral health or substance use treatment setting. + Knowledge of ASAM criteria ... What you will be doing? The Utilization Review (UR) Specialist is a...and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? +… more
- Centene Corporation (Phoenix, AZ)
- …licensure as outlined by the applicable state (BCBA) required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state of Kentucky or ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
- Carle Health (Champaign, IL)
- …is seeking a **Physician Advisor** to help oversee the efficiency of care for our Behavioral Health team over the West, Central, and East regions in Central ... Part-time position (.5 FTE and 100% Virtual) + The Behavioral Health Physician Advisor is responsible for...cases referred by Care Management staff /Social Work (remove) Utilization management and Clinical Denials Team/or other health… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... collective bargaining agreement, seniority, etc. Responsible for identifying potential behavioral health inpatient unit candidates, pre-screening referrals, and… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more