• Behavioral Health Utilization

    Baylor Scott & White Health (Dallas, TX)
    …+ Experience working with Substance use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use ... vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares...quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations… more
    Baylor Scott & White Health (06/07/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral ... behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred… more
    Commonwealth Care Alliance (05/21/25)
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  • Behavioral Health UR Clinician…

    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
    Independent Health (05/15/25)
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  • Behavioral Health Clinical Quality…

    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 ... **JR152864 Behavioral Health Clinical Quality Audit Analyst...outreach interventions, provider education and outreach interventions, medical record review , focus studies and surveys. + Conducts quality of… more
    Elevance Health (05/31/25)
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  • Utilization Review Clinician…

    Centene Corporation (Austin, TX)
    …LMHC license or have a compact RN license with previous behavioral health experience. **Position Purpose:** Performs a clinical review and assesses care ... 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 (06/04/25)
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  • Clinician, Central Access Team

    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
    Eastern Connecticut Health Network (05/03/25)
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  • Utilization Review (UR) Supervisor

    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
    Spectrum Billing Solutions (06/05/25)
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  • Utilization Management Clinical Consultant…

    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. ... /benefit management function. **Required Qualifications** + **_Kentucky Licensed Independent Behavioral Health Clinician (_** **_LPCC, LCSW, LMFT, LPAT_**… more
    CVS Health (06/06/25)
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  • Utilization Management Behavioral

    Humana (Big Stone Gap, VA)
    …+ Experience with utilization review process. + Experience with behavioral change, health promotion, coaching and wellness. + Knowledge of community ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral more
    Humana (05/31/25)
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  • Case Manager Behavioral Utilization

    HCA Healthcare (Richmond, VA)
    …want to join an organization that invests in you as a(an) Case Manager Behavioral Utilization Management? At Chippenham Hospital, you come first. HCA Healthcare ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...difference. We are looking for a dedicated Case Manager Behavioral Utilization Management like you to be… more
    HCA Healthcare (05/20/25)
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