- Highmark Health (Harrisburg, PA)
- …effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource ... utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and… more
- Elevance Health (Las Vegas, NV)
- …call center The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM ), or Behavioral ... laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure...acceptable if all the following criteria are met; performs UM approvals only, reviews requests for Applied Behavioral… more
- Point32Health (MA)
- …. **Job Summary** Under the supervision of the Utilization Management Supervisor, the Behavioral Health (BH) Utilization Management ( UM ) Clinician is ... Enterprise contract requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership within the Behavioral Health … more
- AmeriHealth Caritas (LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... requests for additional information and/or request clarification. The BH UM Reviewer will use his/her professional judgment...in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder… more
- Elevance Health (NC)
- ** Behavioral Health Care Manager I - (Day...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in ... + Monday-Friday 9am-6pm EST + Monday-Friday 11am-8pm EST The ** Behavioral Health Care Manager I - (Day...substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or… more
- Elevance Health (NC)
- ** Behavioral Health Care Manager I (2nd...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure ... by law. **Location: North Carolina** **Work Shift:** Monday- Friday 4PM -12:30AM The ** Behavioral Health Care Manager I (2nd Shift)- North Carolina** is… more
- Elevance Health (Los Angeles, CA)
- ** Behavioral Health - Care Manager II**...LMFT RN or Clinical Psychologist to practice as a health professional within the scope of licensure ... an accommodation is granted as required by law. The ** Behavioral Health - Care Manager II** is...responsible for managing psychiatric or autism facility-based and outpatient professional treatment health benefits through telephonic or… more
- Elevance Health (Roanoke, VA)
- The ** Behavioral Health Care Manager I -...laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure ... substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Indianapolis, IN)
- ** Behavioral Health Care Manager I** _*Ideal...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or… more
- Elevance Health (Indianapolis, IN)
- ** Behavioral Health Care Manager II -...laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral… more
- Health Care Service Corporation (Richardson, TX)
- …UM Plan documents and QI activities. JOB REQUIREMENTS: * Licensed Masters level medical/ behavioral health professional in good standing. * 10 years ... of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for...development of written policies and procedures related to Behavioral Health Group Program, including … more
- University of Michigan (Dearborn, MI)
- …their excellence in scholarship and teaching and are actively engaged in professional and academic service. UM -Dearborn offers ample opportunities for creative, ... teaching statement, research statement, and the names of three professional references to the (INTERFOLIO LINK (https://apply.interfolio.com/173478) ). Teaching and… more
- CVS Health (Tallahassee, FL)
- …other clinical services that are evidence-based. * Work collaboratively with the Behavioral Health , Pharmacy, Member Outreach, Care Management, National Quality ... Utilization Management, Compliance, and other departments to integrate social, behavioral , and physical health and improve clinical...or other presentations (written or oral) that support the health plan in a professional and effective… more
- The Cigna Group (Orlando, FL)
- …the Disney Account Team, Health Coaches, Case Managers, Onsite EAP providers, EACs, Behavioral UM and CM teams to align on cases and hand off appropriately ... Attend all required trainings. + Comply with all Evernorth Behavioral Health policies and Standard Operating Procedures....Health First Aid + CEAP (certified employee assistance professional ) required to obtain within 2 years of employment.… more
- UnityPoint Health (Cedar Rapids, IA)
- … care decision-making. Qualifications + State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication - written & ... on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating… more
- University of Miami (Coral Gables, FL)
- …. The University of Miami's Autism Spectrum Assessment Clinic (https://umasac.psy.miami.edu/) ( UM ASAC), an affiliated clinic of the University of Miami's Center ... for Autism and Related Disabilities (https://www.card.miami.edu/) ( UM CARD), has an open psychologist position available within the Department of Psychology… more
- CVS Health (Austin, TX)
- …is not accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review ... At CVS Health , we're building a world of health...overall healthcare system performance. Education Bachelor's degree preferred/specialized training/relevant professional qualification. Prior Relevant Work Experience 3-5 years Essential… more
- Molina Healthcare (Louisville, KY)
- …prior authorization for outpatient and inpatient services for the KY Medicaid behavioral health population. Strong post-acute level of care experience (Nursing ... Facilities, Acute Inpatient, Rehabilitation, Long Term Acute care hospital, Behavioral Health Facility. Excellent computer multi-tasking skills and good… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …provides administrative support for any of the programs of Utilization Management, Behavioral Health , Quality Management, or Member Care Management. This ... specific contract benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, LMFT, LP, LADC, LBA) with ... Title: Care Manager PreService & Retrospective - Autism Location: Remote Career Area: Health Services About Blue Cross and Blue Shield of Minnesota At Blue Cross… more