• Manager, Utilization Management

    Humana (Columbus, OH)
    …Influences and assists corporate leadership in strategic planning to improve effectiveness of behavioral health utilization management programs. + ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health ) who will utilize their clinical… more
    Humana (05/09/24)
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  • Utilization Management

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (05/03/24)
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  • Manager, Behavioral Health

    Centene Corporation (Oklahoma City, OK)
    …related to member care, provider interactions, and facilitates operations within utilization management . + Manages behavioral health (BH) utilization ... including a fresh perspective on workplace flexibility. **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure… more
    Centene Corporation (05/15/24)
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  • Licensed Behavioral Health

    Humana (Baton Rouge, LA)
    …of our caring community and help us put health first** The Licensed Behavioral Health Utilization Management Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Licensed Behavioral Health Utilization Management Professional 2… more
    Humana (05/21/24)
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  • Utilization Management Clinician-…

    CVS Health (Austin, TX)
    …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... or substance abuse setting required + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
    CVS Health (05/17/24)
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  • Utilization Management Clinician…

    CVS Health (Sandy, UT)
    utilization /benefit management function. Required Qualifications - 3+ years of behavioral health clinical experience in a hospital setting - Must have ... clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
    CVS Health (05/01/24)
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  • Utilization Management Clinician,…

    CVS Health (Sacramento, CA)
    …Monday-Friday standard business hours. No nights, weekends or holidays. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in ... with clients with an Autism Diagnosis - Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in… more
    CVS Health (05/19/24)
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  • Utilization Review/ Management

    Universal Health Services (Highlands Ranch, CO)
    Responsibilities Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in Littleton, CO. Highlands features individual units ... ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access… more
    Universal Health Services (05/08/24)
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  • Utilization Management Coordinator…

    Universal Health Services (Sacramento, CA)
    …mental health , or a related field or RN with prior Utilization Management and Behavioral Health experience. Experience: A minimum of one (1) year ... Department. If you're passionate about working in the behavioral health setting and have the desire...from emotional, behavioral and addiction problems. The Utilization Management Coordinator (MSW, MFT, MA, RN)… more
    Universal Health Services (04/06/24)
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  • Behavioral Health Medical Director…

    CVS Health (Austin, TX)
    …meetings when requested. - Oversight and implementation of the utilization management program for behavioral health services, including monitoring for ... and is responsible for * Leadership and counsel for utilization management * Leadership and participation in case...development of clinical practice standards, policies, and procedures. - Behavioral health care management performance… more
    CVS Health (04/30/24)
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  • Behavioral Health Medical Director…

    CVS Health (Trenton, NJ)
    …meetings when requested* Oversight and implementation of the utilization management program for behavioral health services, including preventing ... for utilization management and case management programs for mental health and substance...the development of clinical practice standards, policies, and procedures* Behavioral health care management performance… more
    CVS Health (05/01/24)
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  • Utilization Management Case Manager

    Universal Health Services (Dearborn, MI)
    Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - ... managed health care process, medical terminology, experience in case management , discharge planning, and/or utilization review preferred. + Familiarity with… more
    Universal Health Services (04/10/24)
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  • Utilization Coordinator

    Universal Health Services (Conway, SC)
    …Part Time RN Utilization Review Coordinator. Utilization Review / Risk Management Lighthouse Behavioral Health Hospital is a 105-bed, acute care ... Responsibilities Job Posting Lighthouse Behavioral Health Hospital is hiring for...clinical and critical thinking skills essential. Working knowledge of utilization management / case management preferred.… more
    Universal Health Services (04/22/24)
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  • Supervisor, Behavioral Health

    Centene Corporation (Tallahassee, FL)
    …network. + Partner with Utilization Management staff to monitor behavioral health utilization to identify and address potential behavioral ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...-or over- utilization . + Oversee subcontracts related to behavioral health services + Assist in recruitment… more
    Centene Corporation (04/25/24)
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  • Utilization Management Coordinator…

    Universal Health Services (Philadelphia, PA)
    …to join our team. Utilization Management (UM) Coordinator Position Fairmount Behavioral Health System is seeking a Utilization Management (UM) ... Responsibilities Located on a 27-acre wooded campus, Fairmount Behavioral Health System is a peaceful,...is one of the nation's largest and most respected health care management companies operating through its… more
    Universal Health Services (04/25/24)
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  • Integrated Care Coordinator - SCRBH

    Spokane County (Spokane, WA)
    …for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health . + Knowledge of federal ... behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health ...Coordinator: + Performs utilization management , utilization review, or concurrent review of behavioral more
    Spokane County (03/18/24)
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  • Support Coordinator

    Healthfirst (NY)
    …Coordinator is assigned to a specific clinical team (such as Care Management , Utilization Management , Behavioral Health , etc.) and may have ... of the healthcare industry working in a Call Center environment or Care/Case Management Department. + Demonstrated ability to document calls into a computer system.… more
    Healthfirst (04/04/24)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
    Centene Corporation (05/18/24)
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  • Clinical Services Trainer (Remote in TX)

    Molina Healthcare (Dallas, TX)
    …& ABILITIES** : + 2 or more years in case, disease or utilization management ; managed care; or medical/ behavioral health settings. + One year of training ... EXPERIENCE** : 5 or more years in case, disease or utilization management ; managed care; or medical/ behavioral health settings. **PREFERRED LICENSE,… more
    Molina Healthcare (05/18/24)
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  • Training & Quality Clinician

    CVS Health (Harrisburg, PA)
    …in a managed care clinical operation environment ( utilization management , case management , and/or behavioral health case management ) required. + ... Bring your heart to CVS Health . Every one of us at CVS ...the training and compliance monitoring of the DSNP Care Management team. They are responsible for conducting audits of… more
    CVS Health (05/01/24)
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