• Care Review Clinician

    Molina Healthcare (Fort Worth, TX)
    …clinical review process of provider requests to ensure that behavioral health services are medically necessary and align with established clinical guidelines, ... **REQUIRED QUALIFICATIONS:** + At least 2 years of health care experience including behavioral health, hospital acute...or emergency room. + Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review more
    Molina Healthcare (07/18/25)
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  • Utilization Review Clinician

    Centene Corporation (Austin, TX)
    …HAVE OUTPATIENT BEHAVIORAL HEALTH EXPERIENCE **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse. ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to...preferred. Experience working with providers and healthcare teams to review care services related to mental health… more
    Centene Corporation (07/23/25)
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  • Care Review Clinician , ABA…

    Molina Healthcare (Fort Worth, TX)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (07/24/25)
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  • Care Review Clinician

    Molina Healthcare (Austin, TX)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term ... in Nursing **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/18/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (San Antonio, TX)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care ... good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/25/25)
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  • Care Review Clinician , PA…

    Molina Healthcare (Fort Worth, TX)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care ... and holidays.** Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (07/17/25)
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  • Care Review Clinician

    Molina Healthcare (Dallas, TX)
    …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (06/27/25)
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  • Lead- Behavioral Health Crisis Professional

    Centene Corporation (Austin, TX)
    …benefit questions. + Perform utilization review functions with behavioral health providers, including care shaping and authorization determinations. ... Master's degree in behavioral health and 4+ years of behavioral health experience. Prior managed care experience and supervisory, training,… more
    Centene Corporation (07/12/25)
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  • Associate Medical Director- Dallas

    CenterWell (Arlington, TX)
    …quality of care , clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in care , ensuring ... in monthly leadership meetings. + Deeply understand, support, and improve primary care clinician performance, through understanding of individual & care more
    CenterWell (07/18/25)
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  • BCBA Clinical Supervisor

    BrightSpring Health Services (San Antonio, TX)
    Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic Supervisor for Youth ABA Line of Business MUST BE A FULLY LICENSED BCBA ... clinician (s) on all changes made to regulations. + Review all billing for BCBAs, BCaBA's, RBTs and Behavior...school districts to provide current information on Spring Health Behavioral Health and Integrated Care Services +… more
    BrightSpring Health Services (05/21/25)
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