- Humana (Indianapolis, IN)
- … first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
- Humana (Richmond, VA)
- …caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
- Centene Corporation (Phoenix, AZ)
- …person meetings at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure ... operations within utilization management. + Oversees the behavioral health (BH) utilization review...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- CVS Health (Sacramento, CA)
- …prior Utilization Management experience. + Valid California unrestricted independent professional behavioral health clinical license **Education** + If ... of mental health and substance abuse disorders + Valid unrestricted independent professional behavioral health clinical license to practice per state… more
- Centene Corporation (Springfield, IL)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Omaha Children's Hospital (Omaha, NE)
- …us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are ... opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management… more
- Omaha Children's Hospital (Omaha, NE)
- …us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are ... opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management… more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional… more
- CVS Health (Oklahoma City, OK)
- …Qualifications** + Must reside in Oklahoma + Oklahoma-licensed RN or Mental Health Professional - Licensed Professional Counselor (LPC), Licensed Marriage ... license + 5+ years of clinical practice experience in behavioral healthcare + 2+ years utilization management...preferred **Education** Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPC, LMFT,) or… more
- Centene Corporation (Tallahassee, FL)
- …experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Molina Healthcare (San Diego, CA)
- …Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- LifeCenter Northwest (Bellevue, WA)
- Organ Utilization Coordinator Job Details Job Location Bellevue HQ - Bellevue, WA Position Type Full Time Salary Range $75918.00 - $110112.00 Salary Job Posting ... Date(s) Start Date 08/05/2025 Description and Qualifications The Organ Utilization Coordinator (OUC) is accountable for overseeing all activities related to the… more
- WellSpan Health (York, PA)
- …to Behavioral Health . Performs a variety of reviews and applies Behavioral Health utilization and consultative services to determine the most ... efficient use of resources to support the behavioral health care goal of appropriate, cost...needs. + Assists with the collection and analysis of utilization patterns. + Brings known or suspected problems of… more
- State of Indiana (Indianapolis, IN)
- …+ Referral Bonus program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for the Public Service Loan ... through access to high quality care and services. You serve as the utilization management subject-matter expert in health care delivery, develops utilization… more
- Elevance Health (Winston Salem, NC)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... ** Utilization Management Medical Director- NC Medicaid** Location: This...directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes. + Identifies and… more
- Monte Nido (Miami, FL)
- …across programs. + Leverage understanding of medical necessity criteria and current behavioral health insurance landscape in verbal and written communications ... care. + Experience providing direct care to individuals with an eating disorder preferred. + Licensed behavioral health clinician/provider, RD, or RN \#montenido more
- Prime Healthcare (Passaic, NJ)
- …program for cancer care. The hospital is also a center of excellence for maternal-child health and outpatient behavioral health services. It is the only ... has been lauded as a "Top 15 Healthcare System" by Truven Health Analytics. For information, visitwww.smh-nj.com. Responsibilities The Utilization review tech… more
- CVS Health (Lawton, OK)
- …coordinating all care management activities with members to evaluate the medical and behavioral health needs to facilitate the member's overall wellness. + ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Banner Health (Glendale, AZ)
- …want to be part of, we want to hear from you. Bring your passion for Behavioral Health to **Banner Thunderbird Medical Center!** Our Behavioral Health ... mental health diagnoses as well as those behavioral health patients whom have co-morbidities that...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
- CVS Health (Orlando, FL)
- …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 40% ... activities with members to ensure that their medical and behavioral health needs are met and to...applications (Teams, Outlook, Word, Excel, etc.) + Licensed mental health professional with current unencumbered license in… more
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