- University of Michigan (Ann Arbor, MI)
- …Required Qualifications Nurse Practitioner + Current licensure to practice as a Registered Nurse and Nurse Practitioner specialty certification in the ... Michigan. + Current specialty certification to practice as an Acute Care Pediatric Nurse Practitioner. + Graduate of an accredited Nurse Practitioner program. +… more
- CVS Health (Richmond, VA)
- …physical and behavioral health clinical issues as they relate to medical management ( UM , CM, DM) provider and system of care issues, behavioral health and human ... services system issues + Supports and encourages CM and UM staff to function as interdisciplinary team, with requisite...is required: LPC, LCSW, LMFT, BCBA, LBA, or an RN with 5+ years of behavioral health experience +… more
- Centene Corporation (Sacramento, CA)
- …with providers regarding program benefits and communicate member needs + Participate in UM and CM clinical rounds to identify potential members + Collaborate with ... external partners (hospitals, vendors, physician groups, internal departments (CM, UM , Analytics, etc.) + Education about Palliative Care/Hospice, symptom… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …TITLE: Utilization Review Clinician PAY RANGE: LVN/LPT $35.00-44.19 Per Hour RN /LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review ... hospital colleagues in a timely, positive manner to resolve UM and patient status issues. Document UM ,...+ Current license as an LCSW, ASW, AMFT, LMFT, RN , LVN, LPT, or LPCC. + Preferred; Master's degree… more
- Dignity Health (Gilbert, AZ)
- … RN License Preferred: + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN ), or UM Certification Training: + Knowledge of managed care and payer ... Coordination Team are dedicated to furthering the mission of the Hospital. The RN Care Coordinator is responsible for overseeing the progression of care and… more
- Elevance Health (Indianapolis, IN)
- …to medically necessary behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... which would provide an equivalent background. + Current active unrestricted license, such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or… more
- Elevance Health (OH)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... an equivalent background. Current active unrestricted license, such as RN LCSW LMSW LMHC LPC LBA (as allowed by...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis… more
- Waystar (Atlanta, GA)
- …of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor in the delivery of AwareUM ... effectiveness of AwareUM technology in creating efficient workflow for UM nurses + Deliver on go-forward product milestones balancing...Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure) + 8+ years of clinical experience in… more
- Elevance Health (NC)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... an equivalent background. Current active unrestricted license, such as RN LCSW LMSW LMHC LPC LBA (as allowed by...if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis… more
- Elevance Health (FL)
- …treatment health benefits through telephonic or written review. The BH Care Manager ( UM ) job progression is primarily a provider-facing role although it does involve ... behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC or (as allowed by applicable… more