- Centene Corporation (Springfield, IL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... time zone with experience in mental health settings and utilization management / review . * Department: PHCO...accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to… more
- CVS Health (Salt Lake City, UT)
- …+ Knowledge of mental health and substance abuse disorders + Managed care/ utilization review experience + Crisis intervention skills + Position requires ... opportunities to promote quality effectiveness of healthcare services and benefit utilization + Consults and lends expertise to other internal and external… more
- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician ** **Monte Nido** **Remote** **Monte Nido has ... within an intimate home setting. We are seeking a Utilization Review Clinician to join...care to individuals with an eating disorder preferred. + Licensed behavioral health clinician /provider, RD, or RN… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida… more
- Molina Healthcare (Las Vegas, NV)
- **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... quality and cost-effective member care. **Knowledge/Skills/Abilities** * Assesses applied behavioral analysis (ABA) services for members - ensuring optimum outcomes,… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under direction, the 2932 Senior Behavioral Health Clinician performs essential duties that include, but are not ... and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties as...techniques. + Knowledge of clinical methods refers to the utilization of the history, culture, socioeconomic background, and environment… more
- City and County of San Francisco (San Francisco, CA)
- …positions can review your application Under general supervision, the 2930 Behavioral Health Clinician performs essential duties that include, but are not ... of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than...Housing and the Department of Public Health can then review your application and contact you directly with details… more
- Dartmouth Health (Keene, NH)
- …critical pathways and outcome measurement preferred. Experience in case management, utilization review and discharge planning preferred. Knowledge of JCAHO/NCQA ... Functioning as a member or the Behavioral Health Team, the Master's Level Clinician...is sensitive to patient needs and expectations, promote effective utilization of resources, and support physician practice, while emphasizing… 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 ... the standard schedule based on business needs **Preferred Qualifications** + Managed care/ utilization review experience + Foster Care population experience +… more
- Atlantic Health System (Morristown, NJ)
- …chart documentation. 8. Incorporates use of criteria sets in context of utilization management. 9. Performs other related duties as assigned. Required: 1. Master's ... - Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well… more
- Molina Healthcare (Everett, WA)
- …degree in a healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of ... a WA state LPN licensure. Candidates with case management, Utilization Management (UM), and direct managed care experience are...good standing, such as LCSW, LPCC or LMFT (for Behavioral Health Care Review Clinicians only). Must… more
- Molina Healthcare (Phoenix, AZ)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
- Molina Healthcare (Ann Arbor, MI)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- Molina Healthcare (Miami, FL)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
- Catholic Charities Family Community Services (Rochester, NY)
- …periodic updates and a closing letter. + Provides information for HMO and payer utilization review as required. + Participates in staff meetings and clinical ... Don't miss out on being a part of something special! **Position Title:** Bilingual Clinician - Outpatient Behavioral Health **Salary Range :** $60,000 to $65,000… more
- Molina Healthcare (Wayne, MI)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- HCA Healthcare (Dallas, TX)
- …interdisciplinary team members, payer representatives, and other parties as appropriate regarding behavioral services** + **Performs utilization review as ... hours volunteering in our communities. As a(an) Licensed Intake Clinician PRN with Medical City Green Oaks Hospital you...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- Dignity Health (Los Angeles, CA)
- …(if Master's level), case management, treatment planning, psychotherapy (if Master's level), and utilization review . The Mental Health Clinician will operate ... **Responsibilities** The Mental Health Clinician provides high quality home/community-based mental health services...with the rules and regulations of the Board of Behavioral Science Examiners. He/she will display professional skills in… more
- Elevance Health (Cincinnati, OH)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN ... _‐_ _centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ **Medical… more
- Commonwealth Care Alliance (Boston, MA)
- …panel of patients incorporates the care of individuals with significant medical, behavioral , and social complexities that require intensive care management and care ... for mentorship to interprofessional team. This can include 1:1 meetings with staff, review of productivity standards, and ensure quality of care standards are met +… more