• Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …FOR WEEKEND AND HOLIDAY ROTATIONS**'** MUST HOLD NORTH CAROLINA BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review more
    Centene Corporation (09/25/25)
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  • Utilization Management - Behavioral

    Humana (Frankfort, KY)
    …+ Psychologist **(PhD)** **Preferred Qualifications** + Experience with utilization review process + Outpatient Behavioral Health experience (mental ... of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health more
    Humana (09/27/25)
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  • Senior Manager, Behavioral Health

    Centene Corporation (Phoenix, AZ)
    …at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care ... within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines… more
    Centene Corporation (09/14/25)
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  • RN - Behavioral Health

    UnityPoint Health (Cedar Rapids, IA)
    …regarding managed care implications - precertification and utilization review procedures. . Provides consultation regarding behavioral health ... the assessment, planning, implementation and evaluation of patient care on the behavioral health units. Responsible for the delivery of patient care through a… more
    UnityPoint Health (09/19/25)
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  • Behavioral Health Utilization

    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 ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
    CVS Health (09/13/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Santa Fe, NM)
    …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (09/24/25)
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  • Utilization Management Clinician…

    CVS Health (Salt Lake City, UT)
    …Knowledge of mental health and substance abuse disorders + Managed care/ utilization review experience + Crisis intervention skills + Position requires ... care setting such as ambulatory care or outpatient clinic/facility. + Unencumbered Independent Behavioral Health clinical license in the state where they work.… more
    CVS Health (09/09/25)
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  • Utilization Management Nurse - 20 hrs wk.…

    Omaha Children's Hospital (Omaha, NE)
    …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. * Appropriately documents all relevant communications… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse…

    Omaha Children's Hospital (Omaha, NE)
    …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. o Appropriately documents all relevant communications… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Review Specialist

    Devereux Advanced Behavioral Health (Malvern, PA)
    …If you answered YES, then consider joining our Devereux Advanced Behavioral Health team! Being a Utilization Review Specialist at Devereux has ... helping individuals in need. Devereux's Children Behavioral Health Center (DCBHC) is currently seeking a Utilization... Health Center (DCBHC) is currently seeking a Utilization Review Specialist to work at their… more
    Devereux Advanced Behavioral Health (09/26/25)
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