• BH Utilization Review

    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
    Commonwealth Care Alliance (05/21/25)
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  • Utilization Review Clinician

    Centene Corporation (Austin, TX)
    … of services + Provides education to providers members and their families regrading BH utilization process + Interacts with BH healthcare providers as ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health ( BH ) inpatient to...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
    Centene Corporation (07/07/25)
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  • Utilization Review Clinician

    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
    Centene Corporation (06/20/25)
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  • Utilization Review Clinician

    Centene Corporation (Springfield, IL)
    … 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
    Centene Corporation (07/04/25)
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  • Clinician , Central Access Team

    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
    Eastern Connecticut Health Network (05/03/25)
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  • License Professional Mental Health

    Veterans Affairs, Veterans Health Administration (Rochester, NY)
    …Team. The incumbent functions as a Licensed Professional Mental Health Counselor (LPMHC) clinician in the Outpatient BH Clinic. Incumbent conducts thorough ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities VA Careers -...statement applies is assigned to the Outpatient Behavioral Health ( BH ) Clinic, and will provide clinical services at the… more
    Veterans Affairs, Veterans Health Administration (07/01/25)
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  • Behavioral Health Clinical Quality Audit Analyst…

    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 (07/03/25)
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