- State of Indiana (Indianapolis, IN)
- … outcomes through access to high quality care and services. You serve as the utilization management subject-matter expert in health care delivery, develops ... Utilization Management Manager Date Posted: Nov...program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for… more
- Brighton Health Plan Solutions, LLC (NC)
- About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit ... criteria sets * Experience with both inpatient and outpatient reviews including Behavioral Health , DME, Genetic Testing, Clinical Trials, Oncology, and/or… more
- Elevance Health (Tampa, FL)
- …is responsible for managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care ... management and/or concurrent review to ensure cost effective utilization of health , mental health , and substance abuse services for one or more member… more
- WellSpan Health (Chambersburg, PA)
- …+ Thoroughly and accurately documents actions/communication surrounding discharge planning and/or utilization management in the medical record. + (BHU Only) ... + (BHU Only) Effectively represents BHU on the hospital Utilization Management Committee + (Inpatient Rehab only)...Education:** + Bachelors Degree In Social Work and Inpatient Behavioral Health may have Bachelor's degree in… more
- AmeriHealth Caritas (Washington, DC)
- …products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity...for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years...and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license… more
- Devereux Advanced Behavioral Health (Viera, FL)
- … Review Coordinator at Devereux has its Advantages!** Devereux Florida is a nonprofit behavioral health organization that provides a wide range of services for ... you looking to advance your career in Admissions & Utilization Review? If you answered yes, then consider joining...**_Position Type_** _Full-Time_ The employment policies of Devereux Advanced Behavioral Health are to recruit and hire… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for members who ... to provide the best quality care. The TeamThe RN Utilization Management Reviewer is part of a...dedicated and motivated team of professionals, including medical and behavioral health care managers, dietitians, pharmacist, clinicians,… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... to determination of appropriateness and authorization of clinical services both medical and behavioral health . This role will focus on Medical Advantage line of… more
- Elevance Health (Norfolk, VA)
- ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for...and experience in medical or insurance field preferred. + Behavioral health medical terminology strongly preferred. +… more