- 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...LMHC). + Minimum of two years of experience in utilization review /case management. + At least one… 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 ... related field, masters in social work, counseling, or other behavioral health related field is required. +...experience is required. **Skills and Abilities** + Ability to review claims history in a medical claims system and… more
- Sutter Health (Berkeley, CA)
- …staff changes, workload, or technical development)._ **DEPARTMENT REQUIRED EDUCATION** Department, Behavioral Health : Master's in Social Work or related field ... with hospital administration, medical staff, patient registration and representatives of review organizations and others to ensure effective utilization of… more
- Centene Corporation (Tallahassee, FL)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- AdventHealth (Glendale Heights, IL)
- …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use...+ Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able… more
- Spectrum Billing Solutions (Skokie, IL)
- …conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or Master's ... for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing...(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. At Spectrum, you… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral ... behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Director of Utilization Review (UR) in a behavioral health setting oversees the UR process, ensuring appropriate and cost-effective care while ... with or without notice. Knowledge Skills and Abilities . Relevant experience in utilization management, behavioral health , or a related clinical setting.… 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 ... vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares...quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations… more
- CVS Health (Columbus, OH)
- …**Preferred Qualifications** + Utilization review experience strongly preferred + Behavioral health experience + Experience in a behavioral health ... state of Ohio. The requirements is for candidates to hold a Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with… more
Related Job Searches:
Behavioral,
Behavioral Health,
Behavioral Health Utilization,
Health,
Review,
Utilization,
Utilization Review