- Monte Nido (Miami, FL)
- …lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician ** **Monte Nido** **Remote - Pacific hours** ... to provide comprehensive care within an intimate home setting. The Utilization Review ** Clinician ** is responsible for conducting daily administrative and… more
- 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
- Centene Corporation (Frankfort, KY)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 8 hr. shifts. 8A-5P** **Position Purpose:** Performs a clinical review and assesses care related to mental health and...Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members… more
- Centene Corporation (New York, NY)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
- Independent Health (Buffalo, NY)
- …culture that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily be responsible for ... managing behavioral health benefits through utilization management functions as well as case management activities. **Qualifications** + Masters level licensed… more
- 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
- 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 (Richmond, 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
- City of Durham (Durham, NC)
- …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. + Ability ... with service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management? + No… more
- Molina Healthcare (Cleveland, OH)
- …who must have a RN OHIO license, or compact RN license The Care Review Clinician will provide prior authorization for OH Medicaid behavioral health population. ... substance use disorders and familiarity with ASAM criteria. Familiarity with utilization management and experience using MCG, PEGA. Excellent computer multi-tasking… more
- Baystate Health (Springfield, MA)
- …meetings to address treatment objectives. **6.** May collaborate as assigned with utilization review specialist to obtain necessary insurance authorizations and ... **Emergency Department Crisis Clinician ** Baystate Health, a nationally recognized leader in...for gathering a psychosocial evaluation through interviews and record review and completing a written assessment with case formulation… 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 (Sacramento, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Inpatient/ Concurrent Review , Utilization Review / Utilization Management and ... **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_3-12 NIGHT SHIFT: 7:30PM - 08:30AM PACIFIC HOURS NON EXEMPT, 3 days a week will rotate._** **_TRAINING SCHEDULE WILL BE… more
- Johns Hopkins University (Baltimore, MD)
- …University seeks an energetic, organized, and motivated **_Senior Mental Health Services Clinician Initial Consultation Team Lead_** to work in a dynamic and ... of a diverse community of learners. The Senior Mental Health Services Clinician Initial Consultation Team Lead will provide direct clinical services and supervise… more
- Molina Healthcare (San Francisco, CA)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... with California providers **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees:… 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
- Hartford HealthCare (Danielson, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and then to the student's home. _*Job Summary*_ Lead Behavioral Health Clinician works in coordination with interdisciplinary teams to organize, prepare, and deliver… 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
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