• Utilization Review Clinician

    Monte Nido (Miami, FL)
    …lives while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician ** **Monte Nido** **Remote** **Monte Nido has ... to provide comprehensive care within an intimate home setting. We are seeking a Utilization Review Clinician to join our team based Remotely. **This is a… more
    Monte Nido (09/06/25)
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  • Utilization Review Clinician

    Centene Corporation (Tallahassee, FL)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
    Centene Corporation (09/30/25)
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  • Utilization Review Clinician

    Centene Corporation (Madison, WI)
    …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... Analyzes BH member data to improve quality and appropriate utilization of services + Interacts with BH healthcare providers...teams to review care services related to Applied Behavior Analysis Services… more
    Centene Corporation (09/26/25)
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  • Mental Health Clinician I

    Dignity Health (Los Angeles, CA)
    …(if Master's level), case management, treatment planning, psychotherapy (if Master's level), and utilization review . The Mental Health Clinician will operate ... **Job Summary and Responsibilities** The Mental Health Clinician provides high quality home/community-based mental health services for children and their families.… more
    Dignity Health (09/11/25)
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  • Associate Medical Director

    CenterWell (Columbia, SC)
    …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics + Review clinician schedules and incentive plans to… more
    CenterWell (09/25/25)
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  • Associate Medical Director

    CenterWell (Daytona Beach, FL)
    …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
    CenterWell (09/11/25)
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  • Associate Medical Director

    CenterWell (Jacksonville, FL)
    …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
    CenterWell (07/22/25)
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  • Market CMO

    CenterWell (Norfolk, VA)
    …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with patient care… more
    CenterWell (09/12/25)
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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 ... opportunities to promote quality effectiveness of healthcare services and benefit utilization + Consults and lends expertise to other internal and external… more
    CVS Health (09/09/25)
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  • Care Review Clinician LPN / LVN

    Molina Healthcare (Dayton, OH)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (09/25/25)
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