- Prime Healthcare (Lynwood, CA)
- …treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health , and Emergency and Trauma Care. In ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/rn-case-manager utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt.… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Molina Healthcare (Reno, NV)
- …to applied behavioral analysis (ABA) services. Responsible for verifying that behavioral health services are medically necessary and align with established ... with the utilization and care management departments to provide ABA and behavioral health therapy (BHT) services to Molina members with autism spectrum… more
- Molina Healthcare (Henderson, NV)
- …experience in an intensive care unit (ICU) or emergency room. ASAM Certification for behavioral health Previous experience with MCG guidelines. At least 2 years ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… 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 ... participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of… more
- Brighton Health Plan Solutions, LLC (NC)
- …pace and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical ... criteria sets * Experience with both inpatient and outpatient reviews including Behavioral Health , DME, Genetic Testing, Clinical Trials, Oncology, and/or… more
- LifeCenter Northwest (Bellevue, WA)
- Organ Utilization Coordinator Job Details Job Location Bellevue HQ - Bellevue, WA Position Type Full Time Salary Range $75918.00 - $110112.00 Salary Job Posting ... Date(s) Start Date 08/05/2025 Description and Qualifications The Organ Utilization Coordinator (OUC) is accountable for overseeing all activities related to the… more
- CVS Health (Dallas, TX)
- …And we do it all with heart, each and every day. **Clinical Case Manager Behavioral Health ** **Position Summary** **_This is a field based role, requiring 75% ... + Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate… more
- Molina Healthcare (GA)
- …professionals in some or all of the following functions: care management, utilization management, behavioral health , care transitions, long-term services ... the following areas: utilization management, care management, care transitions, behavioral health , long-term services and supports (LTSS), or equivalent… more
- Elevance Health (Columbus, OH)
- ** Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health ** , offers superior ... (EST) business hours with** **some weekends based upon organizational/business needs.** The ** Behavioral Health Care Manager II** is responsible for managing… more