- HCA Healthcare (Nashville, TN)
- …intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Behavioral Health Utilization Review RN MSW Parallon. ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Behavioral Health Utilization Review RN MSW for our team to… 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
- Actalent (Sunrise, FL)
- …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... or LPN License. + Minimum of one year of utilization review experience and discharge planning in...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
- Centene Corporation (Tallahassee, FL)
- …behavioral health prior authorizations.** **If you have experience in managed care, behavioral health utilization review , and leadership, we want ... reside in Florida** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members… 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
- Elevance Health (Seven Fields, PA)
- …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 ... **JR152864 Behavioral Health Clinical Quality Audit Analyst...outreach interventions, provider education and outreach interventions, medical record review , focus studies and surveys. + Conducts quality of… 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 (Springfield, IL)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... HOME, AND WILL SUPPORT THE STATE OF ILLINOIS FOR BEHAVIORAL HEALTH MEDICAID AND SOME DUALLY ELIGIBLE...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… 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 (Renton, 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 (Richmond, VA)
- …EST. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health clinical experience ... clinically appropriate treatment, evidence based care an clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. +… more
- CVS Health (Phoenix, AZ)
- …Responsibilities** + Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health and Substance Abuse to evaluate inpatient and ... experience. + Minimum 3 years of clinical experience in Behavioral Health and/or Substance Abuse including acute...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… 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
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days -...preferred. At least two (2) years acute hospital or Behavioral Health patient care experience required. One ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...(1) year hospital acute or behavioral health case management experience preferred. Active… more
- Intermountain Health (Murray, UT)
- …Marketplace Qualified Health Plans, fully funded and self-funded Commercial plans. Utilization Review nurses at Select Health proactively oversee ... closely related field including: Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health , or… more
- Centene Corporation (Sacramento, CA)
- …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