- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician ** **Monte Nido** **Remote** **Monte Nido has ... to provide comprehensive care within an intimate home setting. We are seeking a Utilization Review Clinician to join our team based Remotely. **This is a… more
- Centene Corporation (Springfield, IL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... or eastern time zone with experience in mental health settings and utilization management / review . * Department: PHCO BH UM supporting IL Meridian Medicaid *… more
- Centene Corporation (Tallahassee, FL)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / Florida *...teams to review care services related to Applied Behavior Analysis Services… more
- Dignity Health (Los Angeles, CA)
- …(if Master's level), case management, treatment planning, psychotherapy (if Master's level), and utilization review . The Mental Health Clinician will operate ... **Responsibilities** The Mental Health Clinician provides high quality home/community-based mental health services for children and their families. He/she is… more
- CenterWell (Daytona Beach, FL)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
- CenterWell (Jacksonville, FL)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- CenterWell (Norfolk, VA)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with patient care… more
- CVS Health (Salt Lake City, UT)
- …+ Knowledge of mental health and substance abuse disorders + Managed care/ utilization review experience + Crisis intervention skills + Position requires ... opportunities to promote quality effectiveness of healthcare services and benefit utilization + Consults and lends expertise to other internal and external… more
- Molina Healthcare (Everett, WA)
- …candidate with a WA state LPN licensure. Candidates with case management, Utilization Management (UM), and direct managed care experience are highly preferred. ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- Molina Healthcare (Phoenix, AZ)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **ARIZONA State Specific Requirements:** Must… more
- Molina Healthcare (Ann Arbor, MI)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Molina Healthcare (Las Vegas, NV)
- **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... stay for requested treatments and/or procedures. * Works collaboratively with the utilization and care management departments to provide ABA and behavioral health… more
- Molina Healthcare (Miami, FL)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Catholic Charities Family Community Services (Rochester, NY)
- …periodic updates and a closing letter. + Provides information for HMO and payer utilization review as required. + Participates in staff meetings and clinical ... **BILINGUAL INTEGRATED CLINICIAN ** **Job Details** **Job Location** 79 North Clinton...and Community Services is growing and seeking an** **Bilingual Clinician ** **to join our family!** Catholic Charities Family and… more
- Molina Healthcare (Los Angeles, CA)
- California residents preferred.** **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 DAY SHIFT 7:30AM - 08:30PM PACIFIC HOURS NON EXEMPT, 3 days a week will ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Elevance Health (CA)
- …or equivalent. Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... **Medical Management Clinician Senior** **Location:** This role enables associates to...initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses… more
- Commonwealth Care Alliance (Boston, MA)
- …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
- Molina Healthcare (Wayne, MI)
- …or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If ... you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $26.41 -… more
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