• Behavioral Health Utilization

    HCA Healthcare (Nashville, TN)
    …intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Behavioral Health Utilization Review RN MSW Parallon. ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Behavioral Health Utilization Review RN MSW for our team to… more
    HCA Healthcare (07/05/25)
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  • Utilization Review Specialist,…

    Sutter Health (Berkeley, CA)
    …staff changes, workload, or technical development)._ **DEPARTMENT REQUIRED EDUCATION** Department, Behavioral Health : Master's in Social Work or related field ... with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of… more
    Sutter Health (06/13/25)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... HOME, AND WILL SUPPORT THE STATE OF ILLINOIS FOR BEHAVIORAL HEALTH MEDICAID AND SOME DUALLY ELIGIBLE...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review more
    Centene Corporation (07/04/25)
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  • Utilization Review Intake RN…

    AdventHealth (Glendale Heights, IL)
    …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use...+ Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able… more
    AdventHealth (06/13/25)
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  • Utilization Review (UR) Supervisor

    Spectrum Billing Solutions (Skokie, IL)
    …conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or Master's ... for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing...(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. At Spectrum, you… more
    Spectrum Billing Solutions (06/05/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral ... behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred… more
    Commonwealth Care Alliance (05/21/25)
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  • Supervisor, Behavioral Health

    Centene Corporation (Tallahassee, FL)
    behavioral health prior authorizations.** **If you have experience in managed care, behavioral health utilization review , and leadership, we want ... reside in Florida** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members… more
    Centene Corporation (07/05/25)
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  • Behavioral Health Utilization

    Baylor Scott & White Health (Dallas, TX)
    …+ Experience working with Substance use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use ... vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares...quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations… more
    Baylor Scott & White Health (06/07/25)
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  • Utilization Management Clinical Consultant…

    CVS Health (Columbus, OH)
    …**Preferred Qualifications** + Utilization review experience strongly preferred + Behavioral health experience + Experience in a behavioral health ... state of Ohio. The requirements is for candidates to hold a Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with… more
    CVS Health (07/02/25)
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  • Behavioral Health Utilization

    Actalent (Sunrise, FL)
    …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... or LPN License. + Minimum of one year of utilization review experience and discharge planning in...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
    Actalent (06/29/25)
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  • RN - Behavioral Health

    UnityPoint Health (Cedar Rapids, IA)
    …regarding managed care implications - precertification and utilization review procedures. . Provides consultation regarding behavioral health ... the assessment, planning, implementation and evaluation of patient care on the behavioral health units. Responsible for the delivery of patient care through a… more
    UnityPoint Health (06/21/25)
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  • Utilization Management Clinical Consultant

    CVS Health (Columbus, OH)
    …The Behavioral Health UM Clinician position is designed to clinically review of behavioral health prior authorized services for assigned members. ... the utilization /benefit management function **Required Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered… more
    CVS Health (07/03/25)
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  • Utilization Management Clinical Consultant

    CVS Health (Charleston, WV)
    …the utilization /benefit management function. Required Qualifications: + Licensed independent Behavioral Health clinician or a Registered Nurse (RN) with ... setting required Preferred Qualifications: + Managed care/ utilization review experience preferred + Experience in a behavioral... review experience preferred + Experience in a behavioral health inpatient setting + Ability to… more
    CVS Health (07/03/25)
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  • Utilization Management Clinical Consultant…

    CVS Health (Baton Rouge, LA)
    …weekend and holiday schedules. ​ Preferred Qualifications: + Managed care/ utilization review experience preferred + Experience in a behavioral health ... clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
    CVS Health (07/03/25)
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  • Case management Director- Central Region

    Ascension Health (Indianapolis, IN)
    …understanding of: + Discharge planning + Medicare/Medicaid regulations + Utilization review and management + Behavioral health and social determinants ... date or job transfer date. + Social Worker credentialed from the Indiana Behavioral Health and Human Services Licensing Board obtained prior to hire date or job… more
    Ascension Health (05/30/25)
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  • Utilization Management Clinician…

    CVS Health (Richmond, VA)
    …EST. No weekends or holidays. + 1+ years of utilization review / utilization management required. + 3+ years of behavioral health clinical experience ... clinically appropriate treatment, evidence based care an clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. +… more
    CVS Health (06/25/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Phoenix, AZ)
    …Responsibilities** + Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health and Substance Abuse to evaluate inpatient and ... experience. + Minimum 3 years of clinical experience in Behavioral Health and/or Substance Abuse including acute...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (06/21/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...review medical necessity and discharge planning) **As a health care organization, we have a responsibility to do… more
    Beth Israel Lahey Health (05/11/25)
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  • RN Utilization Review Full Time Days

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review Full Time Days -...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
    Tenet Healthcare (07/03/25)
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  • Registered Nurse Utilization Review

    Intermountain Health (Murray, UT)
    …Marketplace Qualified Health Plans, fully funded and self-funded Commercial plans. Utilization Review nurses at Select Health proactively oversee ... closely related field including: Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health , or… more
    Intermountain Health (07/02/25)
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