• UM Behavioral Health

    Humana (Santa Fe, NM)
    …our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the ... health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and… more
    Humana (09/09/25)
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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 ... **Position Summary** We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team....Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient… more
    CVS Health (08/16/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (Albuquerque, NM)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... this position we are hiring for a float team to support PEGA UM systems throughout multiple states.** **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services… more
    Molina Healthcare (07/12/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Las Cruces, NM)
    …candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health . Candidates with a Behavioral ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members...teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other… more
    Molina Healthcare (08/16/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Albuquerque, NM)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other...field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required… more
    Molina Healthcare (07/24/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Santa Fe, NM)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... teams to promote Molina Care Model + Adheres to UM policies and procedures. **JOB QUALIFICATIONS** **Required Education** Any...field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required… more
    Molina Healthcare (08/31/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (NM)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (08/31/25)
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