- Centene Corporation (Phoenix, AZ)
- …to ensure level of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...licensure as outlined by the applicable state (BCBA) required. Behavioral health clinical knowledge and ability to… more
- WellSpan Health (Chambersburg, PA)
- …**Qualifications** **Minimum Education:** + Bachelors Degree In Social Work and Inpatient Behavioral Health may have Bachelor's degree in Psychology and ... services. Required + Masters Degree In social work (or Psychology for inpatient behavioral health ) Preferred **Work Experience:** + 2 years Relevant experience.… more
- BriteLife Recovery (Englewood, NJ)
- …with ASAM criteria, and a working knowledge of insurance guidelines specific to behavioral health What tasks are required? + Conduct initial and concurrent ... What you will be doing? The Utilization Review (UR) Specialist is a critical member... review, case management, or insurance coordination in a behavioral health or substance use treatment setting.… more
- Elevance Health (Norfolk, VA)
- …terminology training and experience in medical or insurance field preferred. + Behavioral health medical terminology strongly preferred. + For URAC accredited ... ** Utilization Management Representative I** **Location** : This role...skills, and analytical skills. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- CVS Health (Frankfort, KY)
- …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channels. + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
- East Boston Neighborhood Health Center (MA)
- …Locations: 1601 Washington Street Position Summary: Under the direction of the Chief Behavioral Health Officer, the Administrative Director is an agent of change ... overall clinical quality and operations for the Department of Behavioral Health our South End location, which...assigned. 18.Provides programmatic management and oversight of access and utilization data to the entire integrated Care Team while… more
- Fairview Health Services (Minneapolis, MN)
- …and Quality named MHealth Fairview Clinics as one of eight "exemplar" integrated behavioral health primary care models across the country. Integrated care is ... the result of an engaged primary care team and Behavioral Health Clinician providing patient-centered care addressing...determinants of health , and ineffective patterns of health care utilization . At MHealth Fairview, integrated… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- …is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective and ... Overview page + Professional growth and development opportunities + A health work/life balance AS A UTILIZATION REVIEW NURSE , YOU WILL : + Communicate with… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dietitians, pharmacist, clinicians, medical ... Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for...at the right level of care to promote optimal health . This position is self-directed and works independently and… more
- Fairview Health Services (Princeton, MN)
- …and Quality named MHealth Fairview Clinics as one of eight "exemplar" integrated behavioral health primary care models across the country. Integrated care is ... a result of an engaged primary care team and Behavioral Health Clinician providing patient-centered care addressing...determinants of health , and ineffective patterns of health care utilization . At MHealth Fairview, integrated… more