- Elevance Health (CA)
- ** Behavioral Health Care Manager I, Utilization Management** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... an accommodation is granted as required by law. The ** Behavioral Health Care Manager I, Utilization...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review .… more
- Centene Corporation (Springfield, IL)
- …experience in various mental health settings especially inpatient behavioral health units, utilization management / review , and youth or pediatric ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- 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 2 work… more
- Molina Healthcare (Grand Rapids, MI)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- Point32Health (MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** Under the supervision of the Utilization Management Supervisor, the Behavioral Health (BH) ... requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership within the Behavioral...of utilization management and care management principles. Health Plan experience performing utilization review… more
- UNC Health Care (Hendersonville, NC)
- …for behavioral health services. Working closely with behavioral health clinicians, utilization review , case management, and finance teams, the ... This role involves the review , coordination, and tracking of behavioral health referrals, ensures adherence to safety protocols, age-appropriate clinical… more
- Molina Healthcare (AZ)
- …most effective setting while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, ... expertise for utilization management, case management, and integrated behavioral health /chemical dependency programs; collaborates with regional and… more
- Novant Health (NC)
- …needed, most holidays required. + Serve as a leader resource in the Utilization Review process for Behavioral Health acute care . + Coordinate and ... regulatory compliance. + Obtain prior authorization for behavioral health services. + All Utilization Review activities are performed in accordance with… more
- Spectrum Billing Solutions (Skokie, IL)
- …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- CVS Health (Harrisburg, PA)
- …. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health clinical experience ... day. **Position Summary-** + **Master's Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and...years BH clinical Experience** + **1 or more years Utilization Management Experience** + **Work at Home role. Can… more
- AmeriHealth Caritas (Washington, DC)
- …for further review . The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring they meet the patient's ... to efficiently document and assess patient cases + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dietitians, pharmacist, clinicians, medical ... Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating...at the right level of care to promote optimal health . This position is self-directed and works independently and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical leadership in other areas ... your true colors to blue. The Role The Physician Reviewer is responsible for evaluating clinical service requests made...anticipatory case management for members whose cases come for review , in partnership with case managers + Participate in… more
- HCA Healthcare (Dulles, VA)
- …Hospital Center! **Manages the day-to-day operations of the Behavioral Health Nursing Department through effective utilization of self, shift House ... your career path, we encourage you to apply for our Nurse Manager Behavioral Health opening. We review all applications. Qualified candidates will be… more
- CVS Health (Austin, TX)
- …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...Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation… more
- CVS Health (Austin, TX)
- …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...with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- Carle Health (Peoria, IL)
- …guidance to team members, and ensure compliance with IATP standards. LPHA reviewer provides behavioral health assessment, intervention, and consultation ... to individuals and/or groups identified as having behavioral health needs, plans treatment modalities, coordinates...provide crisis evaluation and intervention as needed. The LPHA Reviewer is recognized as a Licensed Practitioner of the… more
- Centene Corporation (Indianapolis, IN)
- …BCBA certification to support our growing markets and ensure high-quality, evidence-based behavioral health care.** **Why Join Us?** + **100% remote ... to clinical excellence** **Position Purpose:** Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical… more
- CVS Health (Phoenix, AZ)
- …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
- Devereux Advanced Behavioral Health (Viera, FL)
- **Description** Are you looking to advance your career in Admissions & Utilization Review ? If you answered yes, then consider joining our team where you can take ... your career to the next level. **Being the Utilization Review Coordinator at Devereux has its...Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide… more
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