• Director , Utilization…

    Commonwealth Care Alliance (Boston, MA)
    … Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. * Ensures that utilization management processes are integrated with care management … more
    Commonwealth Care Alliance (10/02/25)
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  • BH Provider Engagement Program Manager

    Commonwealth Care Alliance (Boston, MA)
    …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: * No, this… more
    Commonwealth Care Alliance (10/18/25)
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  • Behavioral Health Utilization…

    AmeriHealth Caritas (LA)
    **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... and appropriately identify and refer requests to the Medical Director when indicated. The BH UM Reviewers...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
    AmeriHealth Caritas (11/19/25)
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  • Administrative Director for Behavioral…

    East Boston Neighborhood Health Center (MA)
    …policies, procedures, and patient education materials in collaboration with the Medical Director (s). 3.Facilitates in collaboration with the BH Leadership Team ... Epic training team as indicated. 4.In collaboration with the BH Medical Director , designs and implements the...Specialty, and all other clinical programs assigned. 18.Provides programmatic management and oversight of access and utilization … more
    East Boston Neighborhood Health Center (09/25/25)
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  • Medical Director , Behavioral Health

    Molina Healthcare (UT)
    …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management ...and financial goals across all LOBs * Responds to BH -related RFP sections and review BH portions… more
    Molina Healthcare (10/18/25)
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  • Chief Psychiatrist - Behavioral Health Medical…

    Humana (Indianapolis, IN)
    … management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. ... delivery model. **Position Responsibilities:** + Leads clinical and quality management components of Humana's BH services +...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
    Humana (10/23/25)
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  • Medical Director , Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …Accountabilities: Level I + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
    Excellus BlueCross BlueShield (11/12/25)
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  • Director , Care Transitions

    Beth Israel Lahey Health (Beverly, MA)
    …Responsible for the overall operation of care transitions discharge planning and/or utilization management departments through oversight of daily and long-term ... and external stakeholders in clinical care coordination and outcomes management processes. Participates, leads and coordinates multidisciplinary teams/committees supporting… more
    Beth Israel Lahey Health (11/27/25)
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  • Senior Manager Behavioral Health Clinical Strategy

    CVS Health (Harrisburg, PA)
    …clinical interventions, and program frameworks. It requires a working understanding of Utilization Management , Case Management , Quality Management , ... of the Chief Psychiatric Officer and reports to the Executive Director , Behavioral Health Innovation and Enterprise Connectivity. This position demands clinical… more
    CVS Health (12/04/25)
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  • Transitional Care Manager, Behavioral Health

    CVS Health (Oklahoma City, OK)
    …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... stay and identify any barriers to discharge. + Assist Utilization Management team with access to external...in regular meetings with CVS Health regional leaders, Program Director , Project Manager and other Transitional Care Managers on… more
    CVS Health (11/27/25)
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