- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review SpecialistJob Description The Behavioral Health Utilization Review Specialist conducts ... comprehensive utilization management activities for behavioral health plan members. This role includes coordinating services for members in crisis,… more
- Centene Corporation (Austin, TX)
- …IS REMOTE IDEAL CANDIDATE WILL HAVE BCBA CERTIFICATION **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure ... day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Experience working with Substance use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use ... and improving care quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations within the designated… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse!Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ensure ... appropriate service utilization . Working under the general supervision of the Director...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
- Actalent (Sunrise, FL)
- Utilization Management Behavioral Health ClinicianUtilization Management Behavioral Health Clinician We're seeking a dedicated Behavioral ... collaborate with an interdisciplinary team to review and authorize behavioral health and substance use services, ensuring...Conduct utilization reviews and service authorizations for behavioral health and substance use treatments. +… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral health and ... behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily be ... responsible for managing behavioral health benefits through utilization management functions as well as case management activities. **Qualifications** +… more
- Centene Corporation (Austin, TX)
- … health and substance abuse is preferred. + Utilization Review/ Utilization management with behavioral health cases + Precertification, Concurrent ... regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall...and substance abuse is preferred. + Knowledge of mental health and substance abuse utilization review process… more
- Elevance Health (Seven Fields, PA)
- …or related field and a minimum of 3 years' experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed ... **JR152864 Behavioral Health Clinical Quality Audit Analyst Sr** This role is primarily focused on conducting medical record reviews of facilities and clinics in… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …This role directly manages 5-10 This role reports to this job: Manager, Behavioral Health Operations Necessary Contacts: In order to effectively fulfill this ... or a related field, masters in social work, counseling, or other behavioral health related field is required. + Current, unrestricted RN, license in the… more
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