- AmeriHealth Caritas (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
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …a member's benefit coverage while working remotely. Primary Responsibilities * Performs behavioral health clinical utilization reviews using evidenced based ... About The Role BHPS provides Utilization Management services to its clients. The ...* Experience with both inpatient and outpatient reviews for Behavioral Health (examples: TMS, ECT, ABA, Psychotherapy,… more
- PeaceHealth (Bellingham, WA)
- **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary ... monitor for change of status and notify payer. + Provide admission support to Behavioral Health unit/ED/SECU as needed. Assist MSW with initial assessments, as… more
- Molina Healthcare (Bowling Green, KY)
- …dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to ... -related regional medical necessity reviews and cross coverage. * Standardizes behavioral health -related utilization management, quality, and financial… more
- CVS Health (Oklahoma City, OK)
- …to identify and address patient needs (eg care team, social work, behavioral health , utilization management, Hard-to-Reach, Central Telehealth, etc.). ... assurance activities. **What are we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing within the state of… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Purpose:** Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management, Care Management,… more
- 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …with the ability to manage multiple priorities and work independently. Experience in Behavioral Health and Utilization Management is preferred, and ... to manage multiple priorities and work independently. * Experience with Behavioral Health and Utilization Management processes preferred. * Familiarity with… more
- Spectrum Billing Solutions (Skokie, IL)
- …Strong computer skills (Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist #UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
- Health Care Service Corporation (Albuquerque, NM)
- …This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical necessity ... reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity… more