• Behavioral Health Utilization

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... department activities as assigned. Essential Skills + Experience in utilization management, behavioral health , and...mental health . + Proficiency in clinical and utilization review processes. + Current unrestricted Florida… more
    Actalent (10/04/25)
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  • Senior Manager, Behavioral Health

    Centene Corporation (Phoenix, AZ)
    …at our Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care ... within utilization management. + Oversees the behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines… more
    Centene Corporation (09/14/25)
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  • ABA Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …(Word, Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization ... Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist ​#UtilizationReviewSpecialist | #UtilizationManagementSpecialist… more
    Spectrum Billing Solutions (09/01/25)
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  • Utilization Review Specialist

    Devereux Advanced Behavioral Health (Malvern, PA)
    …If you answered YES, then consider joining our Devereux Advanced Behavioral Health team! Being a Utilization Review Specialist at Devereux has ... helping individuals in need. Devereux's Children Behavioral Health Center (DCBHC) is currently seeking a Utilization... Health Center (DCBHC) is currently seeking a Utilization Review Specialist to work at their… more
    Devereux Advanced Behavioral Health (09/26/25)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …FOR WEEKEND AND HOLIDAY ROTATIONS**'** MUST HOLD NORTH CAROLINA BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH)...health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review more
    Centene Corporation (09/25/25)
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  • Behavioral Health Utilization

    CVS Health (Frankfort, KY)
    …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in the state of Kentucky or ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.… more
    CVS Health (09/13/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Workman, MN)
    …be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive appropriate, evidence-based care. You'll ... Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and outpatient...intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (10/04/25)
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  • Utilization Management - Behavioral

    Humana (Frankfort, KY)
    …+ Psychologist **(PhD)** **Preferred Qualifications** + Experience with utilization review process + Outpatient Behavioral Health experience (mental ... of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health more
    Humana (09/27/25)
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  • Utilization Management Nurse - 20 hrs wk.…

    Omaha Children's Hospital (Omaha, NE)
    …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. * Appropriately documents all relevant communications… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse…

    Omaha Children's Hospital (Omaha, NE)
    …opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... Guides admitting physician in protocols for conducting physician to physician review with third-party payers. o Appropriately documents all relevant communications… more
    Omaha Children's Hospital (09/05/25)
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