• Behavioral Health Utilization

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …or relocation to Louisiana is preferred for all positions. **POSITION PURPOSE** The Behavioral Health Utilization Reviewer is responsible for conducting ... clinical reviews of behavioral health service requests, claims, and appeals...decisions. + Document clinical decisions and rationale in the utilization management system. + Communicate determinations to providers and… more
    Blue Cross and Blue Shield of Louisiana (08/16/25)
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  • Behavioral Health Utilization

    AmeriHealth Caritas (Lafayette, LA)
    **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... in Social Work. + Minimum of 2 years of behavioral health experience and substance use disorder...and American Society of Addiction Medicine (ASAM) criterion. + Utilization management experience within a managed care organization desired.… more
    AmeriHealth Caritas (08/29/25)
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  • Manager, Behavioral Health

    Centene Corporation (Jefferson City, MO)
    …on workplace flexibility. BCBA Preferred ABA Team **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure ... management issues related to member care, provider interactions, and facilitates operations within utilization management. + Manages behavioral health (BH) … more
    Centene Corporation (08/27/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers… more
    Centene Corporation (08/23/25)
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  • Behavioral Health Referral…

    UNC Health Care (Hendersonville, NC)
    …consultation for behavioral health services. Working closely with behavioral health clinicians, utilization review, case management, and finance ... health and well-being of the unique communities we serve. Summary: The Behavioral Health Referral Coordinator is responsible for managing and facilitating … more
    UNC Health Care (08/24/25)
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  • Utilization Management Clinician…

    CVS Health (Salt Lake City, UT)
    …we do it all with heart, each and every day. **Position Summary** As a Utilization Management Clinician - Behavioral Health you will utilizes clinical ... navigating multiple systems and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LSW, LISW, LMFT, LMHC, LCSW)… more
    CVS Health (08/21/25)
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  • Utilization Management Clinician…

    CVS Health (Salt Lake City, UT)
    …care setting such as ambulatory care or outpatient clinic/facility. + Unencumbered Independent Behavioral Health clinical license in the state where they work. ... LPCC, LMHCS, LMHC, LMFT, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** + Knowledge of mental … more
    CVS Health (08/21/25)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... central or eastern time zone with experience in mental health settings and utilization management / review....outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and… more
    Centene Corporation (08/21/25)
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  • Clinician, Central Access Team

    Eastern Connecticut Health Network (Manchester, CT)
    …field is required. EXPERIENCE: + Minimum of ten (10) years of experience in the Behavioral Health field with Utilization Review required. + Must have ... POSITION SUMMARY: This position is responsible for maximizing access to inpatient behavioral health care and patient movement for the Department of Behavioral more
    Eastern Connecticut Health Network (08/02/25)
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  • Behavioral Health Consultant

    Adelante (Mesa, AZ)
    health issues and providers education to assist with enhancing primary care utilization of behavioral health interventions + Promote a smooth interface ... Behavioral Health Consultant - Mesa, AZ...+ Demonstrate an understanding of facility organizational structure by utilization of appropriate channels of communication. Maintain consistent, timely… more
    Adelante (08/29/25)
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