- Centene Corporation (Phoenix, AZ)
- …and facilitates operations within utilization management . + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance ... our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review ...to members. Oversees and works with senior leadership on utilization management issues related to member care,… more
- Molina Healthcare (Phoenix, AZ)
- …and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to… more
- Centene Corporation (Phoenix, AZ)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Molina Healthcare (Mesa, AZ)
- …suite/applicable software program(s) proficiency. Preferred Qualifications * Utilization management , care management , behavioral health and/or long-term ... Job Duties * Performs audits of non-clinical staff in utilization management , care management , member...services and supports (LTSS) non-clinical review /auditing experience. To all current Molina employees: If you… more
- Centene Corporation (Phoenix, AZ)
- …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... state (BCBA) required. Master's degree for behavioral health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or… more
- Molina Healthcare (Mesa, AZ)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health ... assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Adelante (Phoenix, AZ)
- Medical Assistant ( Behavioral Health) - West Phoenix Job Details Job Location Adelante Healthcare West Phoenix - Phoenix, AZ Position Type Full Time Education Level ... discharge. The Medical Assistant will work with patients to develop self- management goals, provide insurance, referral, and prior authorization support, and may… more
- CVS Health (AZ)
- …plan medical directors. + Attends and participates in clinical meetings with care management and utilization management . Provides subject matter expertise on ... the direction of the Lead Director, Service Operations, this position will focus on utilization , quality and fraud waste and abuse review for individual cases… more
- Molina Healthcare (Tucson, AZ)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with PEGA helpful. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Molina Healthcare (Chandler, AZ)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
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