- Salud Para la Gente (Watsonville, CA)
- … management within the timelines outlined *Participate in quality initiatives and utilization review activities as requested. *Provide basic support and/or ... Behavioral Health and Case Management. The Associate Director of BH /CM will work closely with the Director of ...for good patient care *Assess and monitor Behavioral Health Clinician engagement in their professional practice and patient care,… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician , Behavioral Health Utilization Review will review behavioral health and ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
- WellSense (Boston, MA)
- …collaborates closely with leaders and staff from other teams and departments, including BH Care Management, BH Utilization Management, medical Care ... Supervisor of BH Clinical Support WellSense Health Plan is a...caseloads to ensure timely and effective service delivery. + Review and provide feedback on case documentation and other… more
- Centene Corporation (Sacramento, CA)
- …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
- CVS Health (Frankfort, KY)
- …care system preferred. + Managed health care experience preferred. **Education** + If BH clinician , minimum of a master's degree in behavioral health field ... to collect program outcome data. + Participate in the review of policies and procedures related to crisis response...on behavioral and physical health, social service needs, and utilization . + Engage in prevention strategy development - early… more
- Centene Corporation (Raleigh, NC)
- … 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
- Eastern Connecticut Health Network (Manchester, CT)
- …clinical information and disseminates to the interdisciplinary treatment team. + Contacts Utilization Review clinician with authorization and follow up ... works in collaboration with Director of CAT, Nurse Managers, Crisis Services, and Utilization Review . Responsible for patient movement across the system. Assists… more
- Elevance Health (Baton Rouge, LA)
- …of 3 years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as well as process ... quality of care investigations and using criteria closes case appropriately or refers to BH Medical Director for further review . + Prepares cases for Peer … more
- Elevance Health (NV)
- Position specific details: The successful candidate will be an independently licensed clinician residing and licensed in Nevada. **Work Hours: 8am-5pm PST** **Work ... outpatient professional treatment health benefits through telephonic or written review . Primary duties may include but are not limited...resources. + Will serve as a resource to other BH Care Managers. + Assists with more complex cases… more
