- South Shore Health (Weymouth, MA)
- …and shares quarterly reports at staff meetings.8. Responsible for the fiscal management of section; assures proper utilization of organization's financial ... needs of each department to assure adequate coverage.c. Meets regularly with Management Team to schedule department wide staffing issues. Collaborates with peers to… more
- Marion County (Salem, OR)
- …manages the planning, development, support and delivery of efficient and high-quality mental health , behavioral health or health administration services ... provide back-up and support to other programs of the Behavioral Health Division with an eye toward...health service areas; public health administration; health integration practices; supervision and performance management ;… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our ... a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day… more
- Beth Israel Lahey Health Behavioral Services (Danvers, MA)
- …Director; application of Quality Assurance and Customer Service Programs, implementation of Utilization Review mechanisms. 3. Assures sound fiscal management of ... confidentiality regulations. Responsible for assuring that relevant facilities meet applicable health and safety standards. 6. Provides overall management of… more
- Humana (Columbus, OH)
- …and help us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral ... years of clinical and Utilization Management experience. The Utilization Management Behavioral Health Nurse completes medical record reviews from… more
- Humana (Columbus, OH)
- …community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… 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
- 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
- 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
- Universal Health Services (Bradenton, FL)
- … Health is currently seeking a Director of Admissions and Utilization Management Palm Shores Behavioral Health Center provides quality mental ... and social challenges. The dedicated professionals at Palm Shores Behavioral Health Center provide quality mental ...provider of the Patriot Support Program. The Director of Admissions/ Utilization Management is responsible for the patient… more
- Universal Health Services (Dearborn, MI)
- Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - ... managed health care process, medical terminology, experience in case management , discharge planning, and/or utilization review preferred. + Familiarity with… more
- Universal Health Services (Conway, SC)
- …Part Time RN Utilization Review Coordinator. Utilization Review / Risk Management Lighthouse Behavioral Health Hospital is a 105-bed, acute care ... Responsibilities Job Posting Lighthouse Behavioral Health Hospital is hiring for...clinical and critical thinking skills essential. Working knowledge of utilization management / case management preferred.… more
- 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
- Centene Corporation (Tallahassee, FL)
- …network. + Partner with Utilization Management staff to monitor behavioral health utilization to identify and address potential behavioral ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...-or over- utilization . + Oversee subcontracts related to behavioral health services + Assist in recruitment… 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 Fairmount Behavioral Health System is Hosting a...is one of the nation's largest and most respected health care management companies operating through its… more
- WellSense (Boston, MA)
- …stakeholders, (customer service, marketing, sales, product, finance, utilization management , pharmacy, behavioral health ) and external stakeholders ... the Vice President of the Senior Vice President of Behavioral Health , the Senior Director of BH...Director of BH Clinical Programs oversees the BH Care Management , BH Utilization Management and… more
- Spokane County (Spokane, WA)
- …for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health . + Knowledge of federal ... behavioral healthcare services, healthcare coordination or authorization and utilization reviews of behavioral health ...Coordinator: + Performs utilization management , utilization review, or concurrent review of behavioral … more
- Healthfirst (NY)
- …Coordinator is assigned to a specific clinical team (such as Care Management , Utilization Management , Behavioral Health , etc.) and may have ... community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Support… 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
- Healthfirst (NY)
- …Coordinator is assigned to a specific clinical team (such as Care Management , Utilization Management , Behavioral Health , etc.) and may have ... of the healthcare industry working in a Call Center environment or Care/Case Management Department. + Demonstrated ability to document calls into a computer system.… more
