- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
- 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 (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
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