• Utilization Review Clinician…

    Centene Corporation (Austin, TX)
    …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 (10/18/25)
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  • Care Review Clinician - Resident…

    Molina Healthcare (TX)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... degree in a healthcare field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of… more
    Molina Healthcare (10/18/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Houston, TX)
    …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 (10/18/25)
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  • Behavioral Health Clinical Quality Audit…

    Elevance Health (Grand Prairie, TX)
    …years experience in quality improvement and/or behavioral health, risk management and/or utilization review in a managed care setting as well as process ... be required. **Preferred Skills, Capabilities, and Experiences:** + Independently licensed behavioral health clinician preferred (LCSW, LPCC, LMFT, Ph.D.,… more
    Elevance Health (10/13/25)
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  • Associate Medical Director- Dallas

    CenterWell (Arlington, TX)
    …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 (10/16/25)
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  • Associate Medical Director-Dallas

    CenterWell (Fort Worth, TX)
    …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 (08/12/25)
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  • BCBA Clinical Supervisor

    BrightSpring Health Services (San Antonio, TX)
    …+ In-service behavior clinician (s) on all changes made to regulations. + Review all billing for BCBAs, BCaBA's, RBTs and Behavior Technicians on a minimum the ... Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic...professional teams. Provide staff/family training on implemented programs. + Review all Functional Behavior Assessments/Behavior Support Plans prior to… more
    BrightSpring Health Services (08/22/25)
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