- Point32Health (MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Provide behavioral health utilization review and care management in order ... to ensure timely and appropriate services for the membership while in Behavioral Health acute and intermediate levels of care and to ensure coordination of … more
- AmeriHealth Caritas (Manchester, NH)
- …that AmeriHealth Caritas New Hampshire's substance use disorder and behavioral health care management, utilization management and quality management ... **Medical Director Substance Abuse Disorder Behavioral Health (New Hampshire)** Location: Manchester,...Reviewing and resolving disputes related to the quality of care . + Assuring a high-performing Utilization Management… more
- Spokane County (Spokane, WA)
- …Health Administrative Service Organization Integrated Care and the Behavioral Health Administrative Services Organization Utilization Review ... Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator: + Performs...management, utilization review, or concurrent review of behavioral health inpatient and outpatient care… more
- BronxCare Health System (Bronx, NY)
- …Qualifications Minimum of three (3) years experience specifically in Behavioral Health Utilization review and casemanagement.Managed Care or Discharge ... Overview The Coordinator- Behavioral Health Utilization Management...identifying delays/barriers to discharge. Knowledge of Medicare, Medicaid, Managed Care and OASIS guidelines, medicalnecessity criteria pertaining to psychiatry… more
- UNC Health Care (Smithfield, NC)
- …**Knowledge/Skills/and Abilities Requirements:** **Job Details** Legal Employer: NCHEALTH Entity: Johnston Health Organization Unit: Behavioral Health Admin ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- CVS Health (Denver, CO)
- …such as ambulatory care or outpatient clinic/facility. * Unencumbered Independent Behavioral Health clinical license in the state where they work. Must ... LMHC, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** *... health and substance abuse disorders * Managed care / utilization review experience * Crisis intervention skills… more
- CVS Health (Harrisburg, PA)
- …appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health . Utilizes clinical experience and skills in a collaborative ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....+ Must have active current and unrestricted Independent clinical behavioral health license in the state of… more
- Centene Corporation (Madison, WI)
- …States **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises ... of BH utilization management team. + Monitors behavioral health (BH) utilization review...performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH care… more
- Centene Corporation (Jefferson City, MO)
- …Licensure and/or Compact State Licensure required Additional Details: * Department: IL Meridian Behavioral Health Utilization Management Pay Range: $25.00 - ... CST or EST time zone with experience in mental health settings and utilization management / review....regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- CVS Health (Tallahassee, FL)
- …working in community based mental health service like Targeted Care Management, Psychosocial Rehabilitation, or related utilization management experience ... This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world....role are Monday-Friday 8:30a-5:00p EST. **Position Summary** The Medicare Behavioral Health Outpatient clinician will be part… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) position ... to our patients. This position is responsible for utilization review, assessment of discharge planning needs and coordination...with the team members who are recognized leaders within health care . Education: + Bachelor's degree in… more
- Sanford Health (Thief River Falls, MN)
- …Hours:** 32.00 **Salary Range:** $26.00 - $41.50 **Department Details** Come join our Behavioral Health team as a Utilization Review Specialist utilizing ... **Careers With Purpose** **Sanford Health is one of the largest and fastest-growing...a team-based approach to patient care in a fun and supportive work environment. Our… more
- Intermountain Health (Murray, UT)
- …programs. Programs include but are not limited to acute, complex medical and social, behavioral health and care coordination programs across the entire ... **Job Description:** The Healthy Connections ( Care Management and Utilization Review) AVP at Select Health oversees development and evaluation of … more
- Stanford Health Care (Palo Alto, CA)
- …preventive care , telemedicine through Teledoc, prescription drug coverage, and behavioral health coverage. Additional incentives exist for healthy choices. ... of America) Why work at Stanford Medicine | Stanford Health Care (SHC)? Here is your opportunity...assistance! **This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization … more
- Commonwealth Care Alliance (Boston, MA)
- …improvement. + Minimum five (5) years of clinical experience in medical or behavioral health care delivery **Required Knowledge, Skills & Abilities:** ... develop and advance the UM program, collaborates with the Behavioral Health UM team the multiple clinical...to utilization management + Demonstrated knowledge of health care industry trends, developments and issues.… more
- CVS Health (Austin, TX)
- …in the development of clinical practice standards, policies, and procedures. - Behavioral health care management performance and coordination with ... meetings when requested. - Oversight and implementation of the utilization management program for behavioral health...guidelines. - Advocate for and implement innovative approaches to behavioral health care , promoting evidence-based… more
- VNS Health (Manhattan, NY)
- …of our members . + Fosters collaboration and coordination between physical health and behavioral health care to enhance integrated member care . Aims ... the development and implementation of the behavioral health sections of the Quality Management (QM)/ Utilization ...latest industry standards, regulatory requirements, and best practices in behavioral health care . required +… more
- CVS Health (Baton Rouge, LA)
- …appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. + ... utilization /benefit management function. **Required** **Qualifications** + Licensed independent Behavioral Health clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT,… more
- CVS Health (Baton Rouge, LA)
- …in the development of clinical practice standards, policies, and procedures. * Behavioral health care management performance and coordination with ... meetings when requested. * Oversight and implementation of the utilization management program for behavioral health...guidelines. * Advocate for and implement innovative approaches to behavioral health care , promoting evidence-based… more
- Hackensack Meridian Health (Belle Mead, NJ)
- … care focus + Minimum five years of clinical experience in a behavioral health care setting. + Excellent written and verbal communication skills. ... The Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral health resource management to review and coordinate the … more