- Health eCareers (Tempe, AZ)
- …Utilization Review Clinician / Clinical Review Nurse to support the Behavioral Health Utilization Management (BH UM) team for AZCH . This position ... with CMS final rule requirements effective January 2026. Responsibilities * Perform utilization review of behavioral health services (prior authorization… more
- Humana (Frankfort, KY)
- **Become 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 2 work… more
- Centene Corporation (Phoenix, AZ)
- …and facilitates operations within utilization management . + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance ... our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review ...to members. Oversees and works with senior leadership on utilization management issues related to member care,… more
- CVS Health (Salt Lake City, UT)
- …+ Knowledge of mental health and substance abuse disorders + Managed care/ utilization review experience + Crisis intervention skills + Position requires ... to other internal and external constituents in the coordination and administration of the utilization /benefit management functions. + Must be able to talk on the… more
- 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 ... a wide variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
- Molina Healthcare (GA)
- …healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... of the following activities: care review , care management , utilization management (prior authorizations,...or more of the following areas: utilization management , care management , care transitions, behavioral… more
- CVS Health (Santa Fe, NM)
- …partial hospitalization and intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior ... promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this… more
- Molina Healthcare (GA)
- …services professionals in some or all of the following functions: utilization management , care management , behavioral health and other programs. Leads ... care experienced in one or more of the following areas: utilization management , care management , care transitions, behavioral health, long-term services… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …delivery of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state of Kentucky or ... the standard schedule based on business needs **Preferred Qualifications** + Managed care/ utilization review experience + Foster Care population experience +… more
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