- HCA Healthcare (Nashville, TN)
- **Description** **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Nurse RN you want with your current ... are a committed, caring group of colleagues. Do you want to work as a Behavioral Health Utilization Review Nurse RN where your passion for creating… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Experience working with Substance use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use ... vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares...quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral ... behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred… more
- Brockton Hospital (Brockton, MA)
- POSITION SUMMARY: The Utilization Review Specialist - Behavioral Health works collaboratively with Administration, Coding, Physicians, Nursing, Social ... entities to secure certification/ reimbursement. Maintains data for required auditing, utilization review , reporting and performance improvement. As prescribed… more
- Elevance Health (Atlanta, GA)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **Be Part of an Extraordinary Team** ** Behavioral Health Clinical Quality Audit Analyst**...appropriately or refers to BH Medical Director for further review . + Travels to worksite and other locations as… more
- Elevance Health (Baton Rouge, LA)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article,… more
- Sutter Health (Berkeley, CA)
- …staff changes, workload, or technical development)._ **DEPARTMENT REQUIRED EDUCATION** Department, Behavioral Health : Master's in Social Work or related field ... with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of… more
- Centene Corporation (Austin, TX)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- Centene Corporation (Trenton, NJ)
- …with regulatory guidelines and criteria + Performs and manages some complex concurrent review of behavioral health (BH) services to determine overall ... needs, and discharge planning + Identifies process improvements opportunities related to BH utilization review processes to improve quality of care services to… more
- Eastern Connecticut Health Network (Manchester, CT)
- …EXPERIENCE: + Minimum of ten (10) years of experience in the Behavioral Health field with Utilization Review required. + Must have experience in ... This position is responsible for maximizing access to inpatient behavioral health care and patient movement for...with Director of CAT, Nurse Managers, Crisis Services, and Utilization Review . Responsible for patient movement across… more
- Spectrum Billing Solutions (Skokie, IL)
- …conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or Master's ... for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing...(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. At Spectrum, you… more
- AdventHealth (Glendale Heights, IL)
- …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use...+ Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able… more
- Pacific Medical Centers (Seattle, WA)
- …ongoing + 5 years Clinical experience. + 2 years In a Behavioral Health setting. + Utilization review /case management. **Why Join Providence?** Our ... Managed Care patient in order to assure cost effective, appropriate utilization of health care resource. Case Manager manages, directs, and coordinates the… more
- CVS Health (Raleigh, NC)
- …operation and work schedules will include weekends, holidays, and evening hours._ As a Utilization Management Clinician - Behavioral Health you will utilizes ... and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LMSW, LSW,...and substance abuse disorders + Managed care experience + Utilization review experience + Crisis intervention skills… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...review medical necessity and discharge planning) **As a health care organization, we have a responsibility to do… more
- Centene Corporation (Lincoln, NE)
- …degree for behavioral health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment to ... text outlines the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate use of hospital… more
- AmeriHealth Caritas (Newark, DE)
- …Director for further review . The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring they meet the ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
- BriteLife Recovery (Englewood, NJ)
- …in utilization review , case management, or insurance coordination in a behavioral health or substance use treatment setting. + Knowledge of ASAM criteria ... What you will be doing? The Utilization Review (UR) Specialist is a...and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? +… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a NICU Utilization Review Services RN? At Parallon, you come first. HCA Healthcare has committed ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...a difference. We are looking for a dedicated NICU Utilization Review Services RN like you to… more