- Centene Corporation (Carson City, NV)
- … of services + Provides education to providers members and their families regrading BH utilization process + Interacts with BH healthcare providers as ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician , Behavioral Health Utilization Review will review behavioral health and ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
- Centene Corporation (Tallahassee, FL)
- …review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers ... education to members and their families regrading ABA and BH utilization process + Provides feedback to...and healthcare teams to review care services related to Applied Behavior Analysis Services… more
- Independent Health (Buffalo, NY)
- …culture that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily be responsible for ... and intervene appropriately is preferred. + Experience using clinical review criteria. + Self-starter with high level of accountability... by assigned medical director, as needed. + Perform utilization of behavioral health ( BH ) services for… more
- Baystate Health (Springfield, MA)
- …meetings to address treatment objectives. **6.** May collaborate as assigned with utilization review specialist to obtain necessary insurance authorizations and ... **Emergency Department Crisis Clinician ** Baystate Health, a nationally recognized leader in...for gathering a psychosocial evaluation through interviews and record review and completing a written assessment with case formulation… more
- Eastern Connecticut Health Network (Manchester, CT)
- …clinical information and disseminates to the interdisciplinary treatment team. + Contacts Utilization Review clinician with authorization and follow up ... works in collaboration with Director of CAT, Nurse Managers, Crisis Services, and Utilization Review . Responsible for patient movement across the system. Assists… more
- Whitney Young Health Center (Albany, NY)
- …Health Service Lines serves as an integral member of the Behavioral Health ( BH ) leadership team. Reporting directly to the Chief Behavioral Health Officer (CBHO), ... RESPONSIBILIRIES: (In collaboration with the CBHO) . Conducts program(s) utilization /management audits necessary to maintain clinical processes, practices and… more
- CenterWell (Carson City, NV)
- …consistent and standardized program workflows, dyad communication/partnership, and quarterly business review of acute care and post-acute care utilization . + ... and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with...credible leader with deep understanding and empathy for the clinician and patient pain points in day-to-day panel management… more
- CVS Health (Mundelein, IL)
- …outpatient clinic, PCP office, or member's residence. The Clinical Care Manager - BH is responsible for care coordination and case management for members, up to ... experienced a behavioral health crisis event. The Clinical Case Manager - BH : Utilizes advanced clinical judgment and critical thinking skills to facilitate… more
- Elevance Health (Seattle, WA)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... Medical Director** is responsible for serving as the lead clinician for a plan. Responsible for the administration of...responsible for working with the CMO, Behavioral Health CMO ( BH -CMO), Pharmaceutical director and the whole health director to… more