- Monogram Health (Fort Myers, FL)
- …populations Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management , and risk adjustment Current state medical ... specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health , and palliative care to diagnose and… more
- HCA Healthcare - Chief Medical Officer (Bradenton, FL)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
- CVS Health (Harrisburg, PA)
- …. No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... day. **Position Summary-** + **Master's Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and...years BH clinical Experience** + **1 or more years Utilization Management Experience** + **Work at Home… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination ... Program required; Bachelor's degree in Nursing preferred. Minimum Experience: Previous Behavioral Health Utilization Management or Care Management… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate,...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Molina Healthcare (North Las Vegas, NV)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- Elevance Health (Indianapolis, IN)
- …call center The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM), or Behavioral ... + MS in social work, counseling, psychology or related behavioral health field or a degree in...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
- Point32Health (MA)
- …. **Job Summary** Under the supervision of the Utilization Management Supervisor, the Behavioral Health (BH) Utilization ... requirements. The BH UM Clinician works collaboratively with the Behavioral Health leadership within the Behavioral...credential. Must demonstrate sound knowledge of utilization management and care management principles. Health… more
- UnityPoint Health (Cedar Rapids, IA)
- …This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves ... a fulfilling career and make a difference with UnityPoint Health . Responsibilities Utilization Management +...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication… more
- CVS Health (Baton Rouge, LA)
- …housing, rentals) * Collaborate with care management and utilization management teams in monitoring behavioral health services, assure assessments ... with heart, each and every day. **Position Summary** The Utilization Management Coordinator/UMNC assists in ensuring that...health agencies, as needed * Coordinate with care management team and monitoring care plans ensuring members are… more
- Immigration and Customs Enforcement (Washington, DC)
- …Perform other duties and responsibilities as assigned. 16. Utilization review/ management for inpatient behavioral health hospitalization for IHSC. ... Summary The Behavioral Health Case Manager is a...case coordination/ management , monitoring high risk individuals, independent behavioral health reviews, behavioral … more
- Molina Healthcare (Columbus, OH)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- Molina Healthcare (AZ)
- …while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective ... psychiatric leadership and clinical expertise for utilization management , case management , and integrated behavioral health /chemical dependency… more
- Molina Healthcare (Albuquerque, NM)
- …or all of the following functions: utilization management , care management , care transitions, behavioral health , long-term services and supports ... care services (HCS) functions: care management , care transitions, utilization management , behavioral health and/or nurse advice line. Demonstrates… more
- Molina Healthcare (TX)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management , Care Management , Quality, and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Services Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health , Quality ... tasks under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management system, department… more
- CVS Health (Frankfort, KY)
- …clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... + Must reside in Kentucky or bordering Counties + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT,… more
- CVS Health (Austin, TX)
- …applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review experience ... At CVS Health , we're building a world of health...Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and… more
