- 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
- Molina Healthcare (Yonkers, NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... 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
- MVP Health Care (Tarrytown, NY)
- …. The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This ... difference for our customers in every interaction **Your key responsibilities:** + Review all requests for behavioral health services utilizing the appropriate… more
- State of Connecticut, Department of Administrative Services (Danbury, CT)
- …+ Prepares and/or reviews reports, medical records and correspondence; + Performs utilization review and management functions; + Attends court hearings as ... mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective and… more