• Utilization Management

    Humana (Frankfort, KY)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (09/27/25)
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  • Senior Manager, Behavioral Health

    Centene Corporation (Phoenix, AZ)
    …to member care, provider interactions, and facilitates operations within utilization management . + Oversees the behavioral health (BH) utilization ... person meetings at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure… more
    Centene Corporation (09/14/25)
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  • Utilization Management Clinician…

    CVS Health (Salt Lake City, UT)
    …care setting such as ambulatory care or outpatient clinic/facility. + Unencumbered Independent Behavioral Health clinical license in the state where they work. ... LPCC, LMHCS, LMHC, LMFT, LCSW) OR RN with 3+ years of clinical behavioral health experience required. **Preferred Qualifications** + Knowledge of mental … more
    CVS Health (09/09/25)
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  • Utilization Management Clinician…

    CVS Health (TX)
    …standard business hours. No nights, weekends or holidays. As a **UM Clinician Behavioral Health ** you will: - Utilize clinical experience and skills in ... management function. **Required Qualifications** - Valid unrestricted independent professional behavioral health clinical license to practice per state… more
    CVS Health (09/23/25)
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  • Utilization Management Nurse…

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse…

    CVS Health (Santa Fe, NM)
    …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate,...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
    CVS Health (09/24/25)
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  • Manager, Healthcare Services; Utilization

    Molina Healthcare (GA)
    …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… more
    Molina Healthcare (09/19/25)
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  • Nurse Supervisor, Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties** * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
    Molina Healthcare (09/25/25)
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  • Case Manager, RN or Licensed Behavioral

    Excellus BlueCross BlueShield (Dewitt, NY)
    …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Director, Healthcare Services; Utilization

    Molina Healthcare (GA)
    …some or all of the following functions: utilization management , care management , behavioral health and other programs. Leads team responsible for ... following key health care services functions: care management , utilization management , care transitions,...following areas: utilization management , care management , care transitions, behavioral health ,… more
    Molina Healthcare (09/19/25)
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