- Centene Corporation (Jackson, MS)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review… more
- Centene Corporation (Tallahassee, FL)
- …behavioral health prior authorizations.** **If you have experience in managed care, behavioral health utilization review , and leadership, we want ... Reside in Florida.** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members… more
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily ... be responsible for managing behavioral health benefits through utilization management functions as...services requested for the diagnosis and treatment of members' health conditions, applying established clinical review criteria,… more
- Sutter Health (Berkeley, CA)
- We are so glad you are interested in joining Sutter Health ! **Organization:** ABSMC-Alta Bates Herrick Campus **Position Overview:** Provides a variety of ... for replacement. COMPLIANCE: *Maintains strictest confidence of all patients protected health information (PHI) and protects all PHI from accidental, intentional, or… more
- Elevance Health (Seven Fields, PA)
- …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 ... **JR150201 Behavioral Health Clinical Quality Auditor Analyst...appropriately or refers to BH Medical Director for further review . + Prepares cases for Peer Review … more
- Eastern Connecticut Health Network (Manchester, CT)
- …EXPERIENCE: + Minimum of ten (10) years of experience in the Behavioral Health field with Utilization Review required. + Must have experience in ... This position is responsible for maximizing access to inpatient behavioral health care and patient movement for...with Director of CAT, Nurse Managers, Crisis Services, and Utilization Review . Responsible for patient movement across… more
- Spectrum Billing Solutions (Skokie, IL)
- …conference reviews. Minimum requirements: + 3-5 years of experience in utilization review for behavioral health services. + Bachelor's or Master's ... for healthcare organizations. We are looking to add a Utilization Review (UR) Supervisor to our growing...(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. At Spectrum, you… more
- Tufts Medicine (Malden, MA)
- …strategic plan, ensuring integration with Tufts Medicine's overall behavioral health strategy. + Oversee clinical resource management, utilization review ... system in Massachusetts, and Acadia Healthcare, the nation's largest standalone behavioral health provider, have partnered to establish the Tufts Medicine… more
- CVS Health (Raleigh, NC)
- …operation and work schedules will include weekends, holidays, and evening hours._ As a Utilization Management Clinician - Behavioral Health you will utilizes ... and keyboarding + Must have active current and unrestricted Behavioral Health clinical licensure (LPC, LMSW, LSW,...and substance abuse disorders + Managed care experience + Utilization review experience + Crisis intervention skills… more
- CVS Health (Harrisburg, PA)
- …EST. No weekends or holidays. - 1+ years of utilization review / utilization management required - 3+ years of behavioral health clinical experience ... clinically appropriate treatment, evidence based care an clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus. -… more
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