- Excellus BlueCross BlueShield (Dewitt, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health , Pharmacy, Registered Dietitian ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- Omaha Children's Hospital (Omaha, NE)
- …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... * Appropriately documents all relevant communications in EPIC. + Ensures appropriate utilization of observation and inpatient status from admission to discharge. *… more
- CVS Health (Columbus, OH)
- …the utilization /benefit management function **Required Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered ... And we do it all with heart, each and every day. **Position Summary** The Behavioral Health UM Clinician position is designed to clinically review of … more
- Helio Health Inc. (Syracuse, NY)
- …mission to treat and promote recovery from the effects of substance use, mental health disorders, and other behavioral healthcare issues. To support the mission ... Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,...experience in utilization review in a hospital, health care, or managed care setting. + Knowledge of… more
- Molina Healthcare (Sacramento, CA)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... interdepartmental integration and collaboration to enhance the continuity of care including Behavioral Health and Long-Term Care for Molina members. + Ensures… more
- Commonwealth Care Alliance (Boston, MA)
- …improvement. * Minimum five (5) years of clinical experience in medical or behavioral health care delivery Required Knowledge, Skills & Abilities: * Medicare ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
- LifeCenter Northwest (Bellevue, WA)
- Organ Utilization Coordinator Job Details Job Location Bellevue HQ - Bellevue, WA Position Type Full Time Salary Range $75918.00 - $110112.00 Salary Job Posting ... Date(s) Start Date 08/05/2025 Description and Qualifications The Organ Utilization Coordinator (OUC) is accountable for overseeing all activities related to the… more
- Brighton Health Plan Solutions, LLC (NC)
- …criteria sets * Experience with both inpatient and outpatient reviews including Behavioral Health , DME, Genetic Testing, Clinical Trials, Oncology, and/or ... About The Role BHPS provides Utilization Management services to its clients. The ... Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review… more
- CVS Health (Dallas, TX)
- …And we do it all with heart, each and every day. **Clinical Case Manager Behavioral Health ** **Position Summary** **_This is a field based role, requiring 75% ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more