• Utilization Management

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (01/08/26)
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  • Utilization Management Clinician…

    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
    CVS Health (01/03/26)
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  • Utilization Management Applied…

    Humana (Richmond, VA)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (01/07/26)
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  • Utilization Management Nurse…

    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
    CVS Health (12/13/25)
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  • Supervisor, Healthcare Services (RN,…

    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
    Molina Healthcare (01/02/26)
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  • Clinical Reviewer, Behavioral Health

    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
    Point32Health (12/23/25)
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  • RN - Utilization Review

    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
    UnityPoint Health (11/07/25)
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  • Medical Director - Health Care…

    Henry Ford Health System (Troy, MI)
    …implements and executes strategies for related to HAP's population health focus (care management , utilization management , behavioral health ) to ... and authority KEY RELATIONSHIPS:Senior Vice President, Chief Medical Officer AVP, Population Health Management AVP, Quality Improvement and Management Senior… more
    Henry Ford Health System (01/08/26)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Grand Rapids, MI)
    …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
    Molina Healthcare (01/06/26)
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  • Behavioral Health Case Manager (O-5)…

    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
    Immigration and Customs Enforcement (12/07/25)
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  • Manager, Healthcare Services - Remote in Ohio

    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
    Molina Healthcare (01/04/26)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …experience in various mental health settings especially inpatient behavioral health units, utilization management / review, and youth or pediatric ... services.** Additional Details: * Department: Illinois Utilization Management * Business Unit: Illinois Health Plan * Schedule: Monday through Friday 8-4:30… more
    Centene Corporation (01/09/26)
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  • Supervisor, Healthcare Services

    Molina Healthcare (Bowling Green, KY)
    …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
    Molina Healthcare (01/07/26)
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  • ABA Utilization Review (UR) Specialist

    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
    Spectrum Billing Solutions (10/30/25)
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  • Senior Medical Director, Behavioral

    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 (01/02/26)
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  • Remote Supervisor, Healthcare Services - Must…

    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
    Molina Healthcare (12/26/25)
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  • Chief Medical Officer, Behavioral

    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
    Centene Corporation (11/09/25)
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  • Behavioral Health Care Manager I,…

    Elevance Health (CA)
    ** Behavioral Health Care Manager I, Utilization Management ** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... is granted as required by law. The ** Behavioral Health Care Manager I, Utilization Management ** is responsible for managing psychiatric and substance… more
    Elevance Health (01/08/26)
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  • Utilization Management Clinical…

    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 (12/31/25)
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  • Utilization Management Nurse…

    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
    CVS Health (01/01/26)
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