• Utilization Review Clinician…

    Centene Corporation (Columbus, OH)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... time zone with experience in mental health settings and utilization management / review . * Department: PHCO...accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to… more
    Centene Corporation (06/13/25)
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  • RN Care Review Clinician , Inpatient…

    Molina Healthcare (Cleveland, OH)
    …Nurse who must have a RN OHIO license, or compact RN license The Care Review Clinician will provide prior authorization for OH Medicaid behavioral health ... substance use disorders and familiarity with ASAM criteria. Familiarity with utilization management and experience using MCG, PEGA. Excellent computer multi-tasking… more
    Molina Healthcare (06/13/25)
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  • Care Review Clinician , PA (RN)…

    Molina Healthcare (Akron, OH)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... transplants; the ideal candidate will have experience either in utilization review or case management for transplants....an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
    Molina Healthcare (06/06/25)
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  • Foster Care Clinical Supervisor

    Sevita (Cleveland, OH)
    …+ May develop and implement crisis intervention emergency procedures, oversee Utilization Review , Quality Assurance, investigations, and internal evaluations. + ... **Mentor Behavioral Health** **,** a part of the Sevita...career well lived. **Clinical Supervisor** Are you an experienced clinician with supervisory experience, looking for more rewarding work?… more
    Sevita (05/15/25)
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