- Kepro (Richmond, VA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (part-time) to join our growing ... team. Job Summary: Our Behavioral Health Utilization Management Clinical Reviewer will use clinical expertise to review medical records against… more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- ** Behavioral Health UM Review** Location: Palm Beach Gardens, FL Primary Job Function: Behavioral Health ID**: 31415 Your career starts now. We are ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
- CVS Health (Salt Lake City, UT)
- …Time (PST), or Arizona time zones. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in a collaborative process to ... utilization/benefit management function. Required Qualifications - Valid unrestricted independent professional behavioral health clinical license to practice… more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- …opportunities and refer those cases to Population Health as needed. The Clinical Care Reviewer UM will apply independent medical judgment to medical ... ** Clinical Care Reviewer UM ** Location: Palm...care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.… more
- Molina Healthcare (Dallas, TX)
- …management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical auditing/review experience. To all ... + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case...UM ), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors… more
- Universal Health Services (Memphis, TN)
- Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate ... paid time off. Since 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and Mid-South… more
- AmeriHealth Caritas (Orlando, FL)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... of business within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your...Excellence in the identification and analysis of medical and behavioral health information in order to develop… more
- AmeriHealth Caritas (Palm Beach Gardens, FL)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... **Supervisor UM Review** Location: Palm Beach Gardens, FL Primary...now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate… more
- Elevance Health (Louisville, KY)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Atlanta, GA)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Rancho Cordova, CA)
- …The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Cerritos, CA)
- …training, or as otherwise required by managers. **Shift:** **M-F; 8:30am-5:00pm** Responsible for Behavioral Health Utilization Management (BH UM ), or ... of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. +...clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. + Additional… more
- Corewell Health (Grand Rapids, MI)
- … Manager provides clinical and operational management over all behavioral health programming and services delivered to the organization's membership ... objectives. + Plan and direct all Quality, UM and Clinical regulatory functions of the Behavioral Health department in order to maintain regulatory and… more
- Elevance Health (Rocky Hill, CT)
- ** Behavioral Health Care Manager II** **This...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers ... - Friday 8:30 am to 5 pm EST.** The Behavioral Health Care Manager II is responsible...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health … more
- Elevance Health (Seven Fields, PA)
- …Point office. **Hours:** Monday-Friday 8:00 am -5:00 pm Eastern Standard Time The Behavioral Health Care Manager II is responsible for managing psychiatric and ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Rocky Hill, CT)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health … more
- CVS Health (Tallahassee, FL)
- …experience with these services . Must have active and unrestricted independent Master's level Behavioral Health clinical license in the state of residence ... Hours for this role are Monday-Friday 8:30a-5:00p EST. Position Summary The Medicare Behavioral Health Outpatient clinician will be part of the Medicare… more
- Elevance Health (Rocky Hill, CT)
- …Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental health and substance use ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Palo Alto, CA)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Outreaches to providers as necessary for ... Behavioral Care Manager** **II** is responsible for completing clinical assessments, screenings, and managing crisis calls in a...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Indianapolis, IN)
- …the hired candidate may be asked to work in office as needed.** The ** Behavioral Health Care Manager I** - **Indiana** is responsible for managing psychiatric ... healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more