- Centene Corporation (Phoenix, AZ)
- …to member care, provider interactions, and facilitates operations within utilization management . + Oversees the behavioral health (BH) utilization ... person meetings at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure… more
- Centene Corporation (Atlanta, GA)
- …Eastern Time Zone hours.** **The ideal candidate will have experience in behavioral health utilization management .** **Education/Experience:** Requires ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Molina Healthcare (Rochester, NY)
- …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
- Actalent (Sunrise, FL)
- …and present reports on department activities as assigned. Essential Skills + Utilization management + Behavioral Health + Mental Health + Clinical ... Job Title: Behavioral Health Utilization Review... Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work… more
- Actalent (Sunrise, FL)
- …and present reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health , and mental ... Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing… more
- Elevance Health (Grand Prairie, TX)
- …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **JR167284 Behavioral Health Clinical Quality Audit Analyst, Sr** Responsible for maintaining crisis accreditation and developing, delivering and evaluating… more
- CVS Health (Frankfort, KY)
- …clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. ... ambulatory care or outpatient clinic/facility. + Valid unrestricted independent professional behavioral health clinical license to practice per state regulations… more
- Molina Healthcare (GA)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… more
- Molina Healthcare (Los Angeles, CA)
- …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties** * Assists in implementing health management , care management , utilization management , behavioral health and other program… more