- Brockton Hospital (Brockton, MA)
- POSITION SUMMARY: The Utilization Review Specialist - Behavioral Health works collaboratively with Administration, Coding, Physicians, Nursing, Social ... entities to secure certification/ reimbursement. Maintains data for required auditing, utilization review , reporting and performance improvement. As prescribed… more
- Centene Corporation (Raleigh, NC)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... WORK 10 HOURS.** **THIS ROLE WILL MAINLY SUPPORT MEDICARE BEHAVIORAL HEALTH ALL STATES AND DELAWARE MEDICAID...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- AdventHealth (Glendale Heights, IL)
- …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use...+ Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able… more
- UnityPoint Health (Cedar Rapids, IA)
- …regarding managed care implications - precertification and utilization review procedures. . Provides consultation regarding behavioral health ... the assessment, planning, implementation and evaluation of patient care on the behavioral health units. Responsible for the delivery of patient care through a… more
- CVS Health (Columbus, OH)
- …The Behavioral Health UM Clinician position is designed to clinically review of behavioral health prior authorized services for assigned members. ... the utilization /benefit management function **Required Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered… more
- CVS Health (Frankfort, KY)
- …clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... /benefit management function. **Required Qualifications** + **_Kentucky Licensed Independent Behavioral Health Clinician (_** **_LPCC, LCSW, LMFT, LPAT_**… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...review medical necessity and discharge planning) **As a health care organization, we have a responsibility to do… more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...related field or an RN + Two years of behavioral health work experience. + Professional communication… more
- Centene Corporation (Tallahassee, FL)
- …experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / ... health clinicians preferred. Behavioral health clinical knowledge and ability to review ...Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment to ... text outlines the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate use of hospital… more