• Utilization Review Clinician

    Centene Corporation (Atlanta, GA)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (07/26/25)
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  • Utilization Review Clinician

    Centene Corporation (Atlanta, GA)
    …assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare ... state (BCBA) required. Master's degree for behavioral health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or… more
    Centene Corporation (07/24/25)
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  • Care Review Clinician , ABA…

    Molina Healthcare (GA)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS ... stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to Molina… more
    Molina Healthcare (07/24/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Augusta, GA)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
    Molina Healthcare (07/27/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Augusta, GA)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
    Molina Healthcare (06/20/25)
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  • Care Review Clinician , PA (RN)…

    Molina Healthcare (Atlanta, GA)
    …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician , Inpatient…

    Molina Healthcare (Augusta, GA)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
    Molina Healthcare (06/27/25)
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