- CVS Health (Oklahoma City, OK)
- …Clinical Reviewer (LCSW, LCPC, RN)** Licensed clinical professional with a passion for behavioral health and a strong background in psychiatric care. As a ... LCPC, or RN. + Experience in a psychiatric or behavioral health setting required. + Strong knowledge...utilization review experience preferred + Experience in a behavioral health inpatient setting + Ability to… more
- Health Care Service Corporation (Albuquerque, NM)
- …Autism Spectrum Diagnoses (ASD). **JOB REQUIREMENTS:** **Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, BCBA, ... This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical necessity… more
- Centene Corporation (Sacramento, CA)
- …as assigned. + Complies with all policies and standards. We are seeking a Licensed Clinical Behavioral Health Professional or RN to join our team! The ideal ... candidate will bring expertise in: + Licensed Clinical Behavioral Health Professional or RN...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process… more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... request clarification. The BH UM Reviewer will use his/her professional judgment to evaluate the request to ensure that...in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with initial assessments, as… more
- MVP Health Care (Tarrytown, NY)
- …, and an **Inclusive Workplace** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and ... continuous improvement. To achieve this, we're looking for a ** Professional , Behavioral Health ** to join...with at least 2 years being ASD related + Utilization or Case Management experience in a managed care… 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… more
- CVS Health (Austin, TX)
- …applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review experience ... 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
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
- LifeCenter Northwest (Bellevue, WA)
- …Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that ... and executes strategies to improve organ allocation strategy and organ utilization , collaborates closely with transplant programs and the surgical recovery team… more
- Tenet Healthcare (Detroit, MI)
- …: Minimum Qualifications BSN preferred. At least two (2) years acute hospital or Behavioral Health patient care experience required. One (1) year hospital acute ... we provide a comprehensive benefit package that prioritizes your health , professional development, and work-life balance. The...or behavioral health case management experience preferred. Active… more
- Commonwealth Care Alliance (Boston, MA)
- …improvement. * Minimum five (5) years of clinical experience in medical or behavioral health care delivery Required Knowledge, Skills & Abilities: * Medicare ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
- Centene Corporation (Harrisburg, PA)
- …EASTERN TIME ZONE/CENTRAL TIME ZONE.** **IDEAL APPLICANTS WILL HAVE CHILDREN/ADOLECENT BEHAVIORAL HEALTH EXPERIENCE AND HOLD A PENNSYLVANIA LICENSURE.** ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + Board… more
- State of Indiana (Indianapolis, IN)
- …+ Referral Bonus program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for the Public Service Loan ... through access to high quality care and services. You serve as the utilization management subject-matter expert in health care delivery, develops utilization… more
- Carle Health (Champaign, IL)
- …Financial and Professional Regulation (IDFPR) **Work Experience** **Length of Experience** Behavioral health nursing 3+ years **Or** Behavioral health ... Overview Partners with Behavioral Health leadership to implement and...Counseling **Or** Master's Degree Social Work **Licenses/Certifications** Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and… more
- Banner Health (Scottsdale, AZ)
- …Shift:** Day **Job Category:** Clinical Care For more than 30 years, Banner Behavioral Health Hospital has provided a nationally recognized, behavioral ... program for children, teens and adults faced with psychiatric, behavioral health , or chemical dependency challenges. We...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Banner Health (Glendale, AZ)
- …want to be part of, we want to hear from you. Bring your passion for Behavioral Health to **Banner Thunderbird Medical Center- BTMC!** Our Behavioral ... mental health diagnoses as well as those behavioral health patients whom have co-morbidities that...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Molina Healthcare (Bowling Green, KY)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- Elevance Health (Indianapolis, IN)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... ** Utilization Management Medical Director - Indiana Medicaid** **Location:**...IN Medicaid members. Responsible for the administration of physical health medical services, to ensure the appropriate and most… more
- WellSpan Health (Chambersburg, PA)
- …**Qualifications** **Minimum Education:** + Bachelors Degree In Social Work and Inpatient Behavioral Health may have Bachelor's degree in Psychology and ... services. Required + Masters Degree In social work (or Psychology for inpatient behavioral health ) Preferred **Work Experience:** + 2 years Relevant experience.… more