• Behavioral Health Professional…

    Humana (Baton Rouge, LA)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (08/08/25)
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  • Utilization Management Clinical…

    CVS Health (Frankfort, KY)
    …FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna Better Health of Kentucky. ... management function. **Required Qualifications** + **_Kentucky Licensed Independent Behavioral Health Clinician (_** **_LPCC, LCSW, LMFT, LPAT_** **_)… more
    CVS Health (07/25/25)
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  • Utilization Management Nurse…

    CVS Health (Santa Fe, NM)
    …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate,...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
    CVS Health (08/16/25)
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  • Manager, UM Behavioral Health

    Humana (Oklahoma City, OK)
    …a part of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within… more
    Humana (08/14/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …Shift: 40 Hours Per Week + Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves ... a fulfilling career and make a difference with UnityPoint Health . Responsibilities Utilization Management +...related field or an RN + Two years of behavioral health work experience. + Professional communication… more
    UnityPoint Health (07/22/25)
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  • Behavioral Health Specialist…

    Defense Health Agency (Falls Church, VA)
    …Training (BHTRAINING); BHSL Utilization Management (BHSL UM); Primary Care Behavioral Health (PCBH); and BH Support of Traumatic Brain Injury Treatment ... will use their Behavioral Health expertise to serve as the Behavioral Health Clinical Management Team Lead (BHSL) for the DHN. Employee functions as… more
    Defense Health Agency (07/30/25)
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  • Behavioral Health Clinical Review…

    BlueCross BlueShield of Tennessee (Knoxville, TN)
    … Clinician or RN with at least 3 years of hands\-on psychiatric clinical experience? Our Behavioral Health Utilization Management team is looking for a ... **Join Our Team as a Behavioral Health Clinical Review Manager\!** Are...psychiatric or substance use treatment settings\. Prior experience in utilization management is a plus\. **This is… more
    BlueCross BlueShield of Tennessee (08/16/25)
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  • Case Manager Registered Nurse

    CVS Health (Tallahassee, FL)
    …appropriate member care. . Attends and participates in case rounds, including utilization management rounds for behavioral health and physical health ... Mileage is reimbursed per our company expense reimbursement policy **Preferred Qualifications:** . Behavioral Health Experience . Case management in an… more
    CVS Health (07/31/25)
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  • Intake Representative - McLaren Careers

    McLaren Health Care (Lapeer, MI)
    …Experience working in hospital setting with utilization management , case management or behavioral health . . **Equal Opportunity Employer of ... **Department:** Behavioral Health Admin **Shift:** Days **Daily Work Times:** 12:00 pm - 10:30 pm **Scheduled Biweekly Hours:** 80 **Starting Pay:** $19.37… more
    McLaren Health Care (08/16/25)
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  • Medicaid Provider Materials Lead

    Humana (Columbus, OH)
    …such as provider relations, claims submission and payment, utilization management processes, behavioral health processes, and dispute resolution. ... orientation and annual training materials, including materials specific to behavioral health and long-term care providers to...timelines. + Bachelor's degree and 3+ years of project management experience. + 3+ years of Medicaid or contracting… more
    Humana (08/16/25)
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