- WELLSPACE HEALTH (Sacramento, CA)
- …the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home. Position Summary The Clinical Care Manager delivers indirect patient care ... 1500 Expo Parkway - Sacramento, CA Description Clinical Care Manager Department: Nexus Location: 164 Reports to: UM...full range of quality medical care, dental care, mental health and behavioral health services,… more
- The Judge Group Inc. (San Diego, CA)
- Job Title: Care Manager - Behavioral Health (BH) Client: Magellan Health Location: Remote (California residents only) Start Date: July 7, 2025 End Date: ... the Role Magellan Health is seeking multiple Care Managers - Behavioral Health to support California-based contracts. This role involves monitoring mental… more
- University of Maryland Medical System (Gwynn Oak, MD)
- Company Description Company Description Join the UM Rehab Team! At UM Rehab, we offer an unparalleled opportunity to work in a setting that seamlessly blends ... treating highly complex cases, including coma-emerging patients and individuals with behavioral challenges, ensuring they receive the specialized care needed for… more
- University of Maryland Medical System (Gwynn Oak, MD)
- Company Description Join the UM Rehab Team! At UM Rehab, we offer an unparalleled opportunity to work in a setting that seamlessly blends elements of acute care, ... treating highly complex cases, including coma-emerging patients and individuals with behavioral challenges, ensuring they receive the specialized care needed for… more
- Pennsylvania Medicine (Trenton, NJ)
- …Specialization: Social Sciences Equivalent Experience: * 0-1 years Some previous experience with behavioral health patients is a plus, but will train * 2+ ... work? Summary: Under supervision from the Director and/or Clinical Manager of Outpatient Admissions provide a full range of...customers. 3. Act as a liaison between Administrative staff, UM and Verification department to insure proper and timely… more
- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
- Elevance Health (Wallingford, CT)
- …for Behavioral Health Utilization Management (BH UM ) only The ** Manager Behavioral Health Services** is responsible for Behavioral Health ... Management (BH UM ), or Behavioral Health Case Management (BH CM) or a combination of...or federal requirements that may apply; provided that the manager 's director has one of the types of licensures… more
- Magellan Health Services (Boise, ID)
- …LCSW, LSW, LPC or RN. Minimum 2 years experience post degree in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong ... the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or...influence quality of care. General Job Information Title Care Manager ( UM /UR) - Remote, Idaho Licensed Grade… more
- CenterWell (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization ... and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral ...primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Elevance Health (Cerritos, CA)
- …and depression, and insightful analytics to improve the delivery of care. **Title:** Behavioral Health Care Manager II **Location:** Woodland Hills, CA ... and ensures essential face-to-face onboarding and skill development. The ** Behavioral Health Care Manager II**...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral… more
- Elevance Health (Atlanta, GA)
- …employment, unless accommodation is granted as required by law. **Work Shift:** 8AM -5PM CST ** Behavioral Health Care Manager l** The ** Behavioral ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral… more
- Elevance Health (Ashburn, VA)
- The ** Behavioral Health Care Manager ...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Houston, TX)
- …for autism and depression, and insightful analytics to improve the delivery of care. ** Behavioral Health Care Manager II** Location: **Virtual** - This role ... Friday,** **12:00 pm (EST) to 8:30 pm (EST)** The ** Behavioral Health Care Manager II**...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- AdventHealth (Glendale Heights, IL)
- …you'll need to succeed** + Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able to demonstrate knowledge and skills ... positions + Career Development + Whole Person Wellbeing Resources + Mental Health Resources and Support + Debt-free Education (Certifications and Degrees without… more
- Excellus BlueCross BlueShield (Rochester, NY)
- … health care services. Examples may include: Utilization Management, Quality, Behavioral Health , Pharmacy, Registered Dietitian and Respiratory Therapist + ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- Highmark Health (Harrisburg, PA)
- …strategies and other pharmacy strategy teams to execute on the formulary/utilization ( UM ) and other strategic pharmacy products. This job will be responsible for ... relates to the operations of the Organization's formularies and UM processes such as prior authorizations, exceptions, and other...a utilization management operations setting in a PBM or Health Plan. + Experience with regulatory entities such as… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Manages the Utilization Management ( UM ) team, maintaining effective and efficient processes for determining appropriate ... regulatory and reimbursement requirements of various commercial and government payers. Manages UM department in the context of other Revenue Cycle functions such as… more
- LifePoint Health (Hickory, NC)
- …the beautiful foothills of North Carolina is a 355-bed acute care hospital, 81-bed Behavioral Health facility and more than 70 primary and specialty care ... Job Summary Manager of Case Management in the departments activities...outcome of care management as described in the initial UM plan with regard to resources, appropriateness of care… more
- Sharp HealthCare (San Diego, CA)
- …Sharp Health Plan's (SHP) physicians (Medical Directors (both medical and behavioral health ) and the Physician Reviewers) to coordinate the necessary ... co-management of our members related to their medical, behavioral health and pharmacy needs. This position...needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'… more
- Commonwealth Care Alliance (Boston, MA)
- …that researches, analyzes, develops and disseminates medical policies pertaining to medical and behavioral health services (eg procedures, DME, Part B drugs) ) ... Manager , Medical Policy reports to the Director of UM , and manages the personnel and work of the...and services addressing social determinants of health across all products and geographies in collaboration with… more
