- Methodist Hospital Northeast (San Antonio, TX)
- …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 ... Northeast offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...patient care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill… more
- Centene Corporation (Springfield, IL)
- …experience in various mental health settings especially inpatient behavioral health units, utilization management / review , and youth or pediatric ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- Novant Health (NC)
- …needed, most holidays required. + Serve as a leader resource in the Utilization Review process for Behavioral Health acute care . + Coordinate and ... regulatory compliance. + Obtain prior authorization for behavioral health services. + All Utilization Review activities are performed in accordance with… 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...review and approval. Investigate complaints related to detainee behavioral health care and provides reports as… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- … + Experience in a managed care, case management, or utilization review setting + Strong understanding of behavioral health diagnoses, treatments, ... Position is On-Site The Behavioral Health Nurse - Managed Care...Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during… more
- UNC Health Care (Hendersonville, NC)
- …for behavioral health services. Working closely with behavioral health clinicians, utilization review , case management, and finance teams, the ... This role involves the review , coordination, and tracking of behavioral health referrals, ensures adherence to safety protocols, age-appropriate clinical… more
- CVS Health (Harrisburg, PA)
- …. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health clinical experience ... 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 role. Can… more
- 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 2 work… more
- Elevance Health (CA)
- ** Behavioral Health Care Manager I, Utilization Management** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables ... an accommodation is granted as required by law. The ** Behavioral Health Care Manager I, Utilization...or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review .… more
- CVS Health (Phoenix, AZ)
- …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
- Devereux Advanced Behavioral Health (Viera, FL)
- **Description** Are you looking to advance your career in Admissions & Utilization Review ? If you answered yes, then consider joining our team where you can take ... your career to the next level. **Being the Utilization Review Coordinator at Devereux has its...Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide… more
- UnityPoint Health (Cedar Rapids, IA)
- …site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional communication… more
- Spectrum Billing Solutions (Skokie, IL)
- …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management -...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
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …Behavioral Health Institute is a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. ... access the full range of their benefits through the utilization review process. Requirements + Education: Master's...Luck & we hope to meet you soon! Georgetown Behavioral Health Institute is an equal opportunity… 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
- Centene Corporation (Phoenix, AZ)
- …licensure as outlined by the applicable state (BCBA) required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state of Kentucky or ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
- CVS Health (Austin, TX)
- …not accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review ... 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 cost-effective allocation… more
- Carle Health (Champaign, IL)
- …is seeking a **Physician Advisor** to help oversee the efficiency of care for our Behavioral Health team over the West, Central, and East regions in Central ... Part-time position (.5 FTE and 100% Virtual) + The Behavioral Health Physician Advisor is responsible for...cases referred by Care Management staff /Social Work (remove) Utilization management and Clinical Denials Team/or other health… more
