- CVS Health (Salt Lake City, UT)
- …all with heart, each and every day. **Position Summary** As a Utilization Management Clinician - Behavioral Health you will utilizes clinical experience, ... navigating multiple systems and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LSW, LISW, LMFT, LMHC, LCSW)… more
- CVS Health (Salt Lake City, UT)
- …care setting such as ambulatory care or outpatient clinic/facility. + Unencumbered Independent Behavioral Health clinical license in the state where they work. ... LPCC, LMHCS, LMHC, LMFT, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** + Knowledge of mental … more
- 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
- 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
- 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
- Centene Corporation (Tallahassee, FL)
- …as experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder… more
- Corewell Health (Grand Rapids, MI)
- …in acute care, clinical nursing, multiple clinical settings or behavioral health with utilization management , discharge planning designing patient ... and concurrent requests for admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …or relocation to Louisiana is preferred for all positions. **POSITION PURPOSE** The Behavioral Health Utilization Reviewer is responsible for conducting ... clinical reviews of behavioral health service requests, claims, and appeals...decisions. + Document clinical decisions and rationale in the utilization management system. + Communicate determinations to… more
- Centene Corporation (Springfield, IL)
- …who reside in either central or eastern time zone with experience in mental health settings and utilization management / review. * Department: PHCO ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Oversee and direct work activities of unlicensed clinical staff involved in the utilization management process. + Communicate with ABA providers to gather ... and internal policies. + Participate in the development and refinement of utilization management protocols and clinical review tools. + Collaborate with… more