- Molina Healthcare (Reno, NV)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… more
- Spectrum Billing Solutions (Skokie, IL)
- …+ Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing… more
- CVS Health (Oklahoma City, OK)
- …stakeholders to identify and address patient needs (eg care team, social work, behavioral health , utilization management , Hard-to-Reach, Central ... follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and...we looking for?** **Required Qualifications** + Active RN or Behavioral Health (BH) license in good standing… more
- Centene Corporation (Austin, TX)
- … Health goals for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource ... Provides strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management , Care Management , Quality, and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Services Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health , Quality ... tasks under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management system, department… more
- CDPHP (Latham, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to manage multiple priorities and work independently. Experience in Behavioral Health and Utilization Management is preferred, and familiarity with ... priorities and work independently. * Experience with Behavioral Health and Utilization Management processes preferred. * Familiarity with agile… more
- Centene Corporation (Austin, TX)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- Tenet Healthcare (Detroit, MI)
- … Health patient care experience required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN ... national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention… 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