- Centene Corporation (Phoenix, AZ)
- … issues related to member care, provider interactions, and facilitates operations within utilization management . + Oversees the behavioral health (BH) ... and ensures compliance with applicable guidelines + Reviews and analyzes BH utilization management (UM) activities, over/under utilization , operations,… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Aug 22, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the...program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for the Public… more
- CVS Health (Oklahoma City, OK)
- …years of clinical practice experience in behavioral healthcare + 2+ years utilization management experience is required + 2+ years of experience with ... we do it all with heart, each and every day. **Position Summary** The Manager , UM Clinical Services, conducts oversight and management of clinical team processes… more
- Prime Healthcare (Anaheim, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/218947/case- manager utilization - ... and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management… more
- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director, Utilization Management provides organizational leadership in the operational areas of care management , ... policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …experience within insurance or health care setting in case/disease or utilization management * 3+ years of behavioral health experience * Bachelor's or ... legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Manager Clinical Care Management - Behavioral Health Location:… more
- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... programs and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department regarding the… more
- CVS Health (Orlando, FL)
- …we do it all with heart, each and every day. **Position Summary** : The Clinical Case Manager , Behavioral Health is a work from home field based role with up to ... Social Worker (LCSW) **Preferred Qualifications** + Bilingual Spanish + Managed care/ utilization review experience + Case management and discharge planning… more
- Elevance Health (Winston Salem, NC)
- ** Utilization Management Medical Director- NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be… more
- CVS Health (Lawton, OK)
- …appropriate administration of benefits. + Using holistic approach consults with manager , Medical Directors and/or other physical/ behavioral health support staff ... diverse populations + 1+ year(s) of crisis intervention experience + Managed care/ utilization review experience + Case management and discharge planning… more
- Banner Health (Glendale, AZ)
- …whom have co-morbidities that require an extra level of acute medical care. As a Behavioral Case Manager you will have the opportunity to work with a wide ... want to hear from you. Bring your passion for Behavioral Health to **Banner Thunderbird Medical Center!** Our ...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- Elevance Health (Atlanta, GA)
- …only, and there is licensed staff supervision._ + Previous experience in case management / utilization management with a broad range of experience with ... ** Behavioral Health Care Manager II** **Be...MCG and ASAM experience strongly preferred. + Ohio Medicaid utilization management experience preferred. Please be advised… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Clinical Case Manager Behavioral Health** **Position Summary** This is a remote role, requiring 75% ... Field Experience + Bilingual + Crisis intervention skills preferred + Managed care/ utilization review experience preferred + Case management and discharge… more
- Prime Healthcare (National City, CA)
- …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/224837/discharge-planner utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityParadise… more
- CenterWell (Tallahassee, FL)
- …part of our caring community and help us put health first** The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing ... staff to resolve issues, clarify requirements, and ensure efficient case management . + Provide clear, concise, and courteous information regarding UM processes,… more
- HCA Healthcare (Richmond, VA)
- …individual is recognized. Submit your application for the opportunity below:RN Manager Behavioral HealthRetreat Doctors' Hospital **Benefits** Retreat Doctors' ... may vary by location._** We are seeking a RN Manager Behavioral Health for our team to... or leadership. Preferred - One year previous successful behavioral health nursing management experience, in an… more
- Magellan Health Services (San Diego, CA)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided...directly influence quality of care. General Job Information Title Behavioral Health Care Manager Remote, must be… more
- Elevance Health (Winston Salem, NC)
- …supervision **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... ** Behavioral Health Care Manager I (3rd...preferred. + Bilingual in Spanish is highly preferred + Utilization Management experince is preferred + Previous… more
- CVS Health (Springfield, IL)
- …it all with heart, each and every day. **Position Summary** The Clinical Case Manager , Behavioral Health, is responsible for driving and supporting care ... management and care coordination activities across the continuum of...thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider… more
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