- MetroPlusHealth (New York, NY)
- …come to work being proud of what you do every day. The Behavioral Health Utilization Management ( BH UM) Clinician is responsible for conducting ... communicates all potential quality of care concerns to the BH UM Clinician Team Lead in a...Illness & Substance Use Disorder) experience in managed care utilization review , quality assurance, discharge planning. (Experience… more
- Commonwealth Care Alliance (Springfield, MA)
- …intensive care management and care delivery. Within the CIC Program, The Senior Clinician , Behavioral Health (SBHC) serves as a leader for behavioral health care ... influence the clinical outcomes of assigned patients by impacting acute care utilization , ensuring optimal treatment for behavioral health needs, and closing quality… more
- Molina Healthcare (NM)
- ….** JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services ... teams to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work...At least 2 years of experience with inpatient concurrent review , prior authorization and managed care; Acute care hospital… more
- Centene Corporation (Honolulu, HI)
- … of services + Provides education to providers members and their families regrading BH utilization process + Interacts with BH healthcare providers as ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Centene Corporation (Tallahassee, FL)
- …review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers ... education to members and their families regrading ABA and BH utilization process + Provides feedback to...and healthcare teams to review care services related to Applied Behavior Analysis Services… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …difference, join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and ... Blue Shield of Minnesota Position Title: Care Manager PreService & Retrospective - BH Location: Remote Career Area: Health Services About Blue Cross and Blue Shield… more
- Centene Corporation (San Diego, CA)
- … of services + Provides education to providers members and their families regrading BH utilization process + Interacts with BH healthcare providers as ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health ( BH ) inpatient to...addiction disorders experience is required. + Direct experience with Utilization Review or Utilization Management… more
