- Centene Corporation (Tallahassee, FL)
- …THE WORK SCHEDULE IS MONDAY-FRIDAY, 8AM - 5PM. THESE ROLES WILL BE SUPPORTING BEHAVIORAL HEALTH UTILIZATION MANAGEMENT FOR MEDICAID. **Position ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Humana (Columbus, OH)
- …years of experience in utilization management using MCG guidelines + Behavioral Health Utilization Management , working knowledge of ASAM criteria ... **Become a part of our caring community and help us put health first** The Compliance Utilization Management Nurse 2 reviews utilization management … more
- Ascension Health (Wichita, KS)
- …professional licensure at time of hire. **Additional Preferences** Behavioral Health and/or Utilization Management experience preferred Schedule Varies ... **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. + Review admissions… more
- Penn Medicine (Philadelphia, PA)
- …work? Summary: + Serves as an adjunct to the Director of Behavioral health in coordinating utilization management and auditing in the administrative ... Management , and various other entities across the PPMC Behavioral Health continuum. Responsibilities: + Audits PPMC...+ 1+ years Experience in working behavioral health claims + Certificate in Business Management … more
- Universal Health Services (Philadelphia, PA)
- …to join our team. Utilization Management (UM) Coordinator Position Fairmount Behavioral Health System is seeking a Utilization Management (UM) ... Responsibilities Located on a 27-acre wooded campus, Fairmount Behavioral Health System is a peaceful,...is one of the nation's largest and most respected health care management companies operating through its… more
- Banner Health (Scottsdale, AZ)
- … systems and help make our patients' lives easier. Apply today. Bring your passion for Behavioral Health to Banner Health ! **Banner Behavioral Health ... state-of-the art units for our patients and staff! Banner Behavioral Health Hospital is a voluntary facility...patient's needs. We are looking for a Clinical Information Analyst/ Utilization Management professional with at least one… more
- CVS Health (Salt Lake City, UT)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health . Utilizes clinical experience and skills in a ... to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and...- Must have active current and unrestricted Independent clinical behavioral health license in the state of… more
- FLACRA (Clifton Springs, NY)
- …work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by email. ... PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area...Counseling and Recovery Agency (FLACRA) is a growing, not-for-profit behavioral health and substance abuse treatment provider… more
- CareOregon (Medford, OR)
- …Knowledge of Behavioral Health managed care practice, including utilization management , population health improvement, guideline development, disease ... crisis systems, criminal justice, and law enforcement, and CareOregon's Behavioral Health team in the areas of network management and optimization, program… more
- WellSense (Manchester, NH)
- …services. The Licensed Behavioral Health Clinician works alongside medical Utilization Management and medical Care Management staff, pharmacists, and ... circumstances. Guaranteed $5,000 Sign on Bonus **Job Summary:** The Licensed Behavioral Health Clinician provides care management services at facilities, in… more
- Humana (Indianapolis, IN)
- …integrate the day-to-day administration and strategic management of physical and behavioral health services, including utilization management (UM), ... focusing on quality management , utilization management , discharge planning and/or home health or...or BH leadership experience + Experience in palliative care, behavioral health , or adult medicine. **Scheduled Weekly… more
- Universal Health Services (Sacramento, CA)
- …mental health , or a related field or RN with prior Utilization Management and Behavioral Health experience. Experience: A minimum of one (1) year ... Department. If you're passionate about working in the behavioral health setting and have the desire...from emotional, behavioral and addiction problems. The Utilization Management Coordinator (MSW, MFT, MA, RN)… more
- Universal Health Services (Kingwood, TX)
- …work, mental health or a Nursing degree preferred. Knowledge of behavioral health systems and Utilization Management required. + Minimum of two (2) ... emergency services. We serve children, adolescents, and adults for psychiatric and behavioral health . The hospital also has services in intensive outpatient… more
- Humana (Columbus, OH)
- …+ Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health . + Detailed working knowledge in ... degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management...Working knowledge using Power BI + Registered Nurse or Behavioral Health Licensed Professional. + Managed care,… more
- Point32Health (MA)
- …click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Behavioral Health Psychologist Reviewer will primarily perform utilization management ... any partner entities at the direction of Behavioral Health Medical Director Team Leader for Utilization Management (UM) and/or the Medical Director of… more
- AmeriHealth Caritas (Robbinsville, NJ)
- …the clinical department including triage of calls, care coordination and utilization management . The Behavioral Health Care Manager facilitates access to ... products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... acute hospital admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for...in lieu of the required degree or diploma_ Department, Behavioral Health : Master's in Social Work or… more
- UNC Health Care (Chapel Hill, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- Universal Health Services (Savannah, GA)
- …and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access ... Responsibilities Coastal Harbor Health is currently seeking a Utilization ...to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory… more
- Centene Corporation (Austin, TX)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more