• Utilization Review Clinician

    Centene Corporation (New York, NY)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (06/27/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Yonkers, NY)
    …reliable transportation. **Preferred Experience** Previous experience in ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
    Molina Healthcare (07/04/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Yonkers, NY)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
    Molina Healthcare (06/29/25)
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  • Outpatient Clinician

    Prime Healthcare (Boonton Township, NJ)
    …meetings as required to ensure continuity of care. Completes all required utilization review tasks as assigned. For Outpatient and Residential services/programs ... of hospitals and healthcare facilities include Denville Hospital, Dover Hospital, Behavioral Health Centers in Boonton, Denville, and Parsippany, and an Imaging… more
    Prime Healthcare (07/04/25)
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