- Humana (Indianapolis, IN)
- …and help us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral ... time frame. Individual shift to be discussed during the interview. The Utilization Management Behavioral Health Nurse completes medical record reviews… 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
- 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
- CVS Health (Trenton, NJ)
- …meetings when requested* Oversight and implementation of the utilization management program for behavioral health services, including preventing ... for utilization management and case management programs for mental health and substance...the development of clinical practice standards, policies, and procedures* Behavioral health care management performance… 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Centene Corporation (Jackson, MS)
- …/ Behavioral health . 5+ years of experience in managed care, utilization management , case management , or quality improvement **For Behavioral ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...liaison on utilization , quality improvement and case management activities + For NH Health Plan… 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
- 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