• Utilization Management Nurse Consultant…

    CVS Health (Phoenix, AZ)
    …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... **Position Summary** We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team....Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient… more
    CVS Health (12/13/25)
    - Related Jobs
  • Behavioral Health Utilization…

    AmeriHealth Caritas (LA)
    **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... cases to integrated care management as needed. The BH UM Reviewer will apply medical health benefit...in Social Work + Minimum of 2 years of behavioral health experience and substance use disorder… more
    AmeriHealth Caritas (11/19/25)
    - Related Jobs
  • Case Manager, RN or Licensed Behavioral

    Excellus BlueCross BlueShield (Rochester, NY)
    …those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, ... health care services. Examples may include: Utilization Management, Quality, Behavioral Health , Pharmacy, Registered Dietitian and Respiratory Therapist +… more
    Excellus BlueCross BlueShield (11/20/25)
    - Related Jobs
  • Utilization Management Nurse Consultant…

    CVS Health (Austin, TX)
    …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): + ... is not accepting applicants whose only acute care experience is in behavioral health ) **Preferred Qualifications** + 1+ years' experience Utilization Review… more
    CVS Health (12/14/25)
    - Related Jobs
  • Registered Nurse - University Hospital…

    University of Michigan (Ann Arbor, MI)
    …within the last year + Recent experience completing ECT Assessments + Recent UM -MiChart experience. + Demonstrated knowledge of cognitive behavioral treatment of ... REGISTERED NURSE - University Hospital - Electroconvulsive Therapy (ECT)/ Ketamine...Clinic Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities through excellence in… more
    University of Michigan (12/17/25)
    - Related Jobs
  • Transplant Care Nurse (Remote)

    Highmark Health (Harrisburg, PA)
    …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more
    Highmark Health (12/04/25)
    - Related Jobs
  • Care Review Clinician - NM resident - Licensed LPN…

    Molina Healthcare (NM)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Medicaid recipients. Preference will be given to those whose UM experience is within another MCO like Molina; experience...field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required… more
    Molina Healthcare (10/30/25)
    - Related Jobs
  • Supervisor Home Modification Specialist

    AmeriHealth Caritas (Philadelphia, PA)
    …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay… more
    AmeriHealth Caritas (11/13/25)
    - Related Jobs
  • Care Manager PreService & Retrospective - Autism

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, ... Title: Care Manager PreService & Retrospective - Autism Location: Remote Career Area: Health Services About Blue Cross and Blue Shield of Minnesota At Blue Cross… more
    Blue Cross and Blue Shield of Minnesota (12/18/25)
    - Related Jobs
  • RN Case Manager - Value Based Service Org - Full…

    University of Southern California (Alhambra, CA)
    …10. Demonstrates collaborative working relationship with care team members, including pharmacy, behavioral health , field team, office staff, and facility staff. ... coordination services evaluating options and services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a… more
    University of Southern California (11/19/25)
    - Related Jobs