• Manager , Utilization

    Humana (Frankfort, KY)
    …our caring community and help us put health first** The Manager , Behavioral Health Utilization Management uses clinical knowledge, communication skills, ... managers across the department. **_Detailed Responsibilities include:_** Leads Kentucky Medicaid Behavioral Health Utilization Management process and teams… more
    Humana (04/26/25)
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  • Manager , Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine...evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational,… more
    Stanford Health Care (02/22/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
    Beth Israel Lahey Health (04/16/25)
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  • Case Manager - PVH Utilization

    Prime Healthcare (National City, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205657/case- manager pvh- utilization - management ... emergency services. In addition to our healthcare services, we offer comprehensive behavioral health services on the hospital campus and Bayview campus in Chula… more
    Prime Healthcare (04/25/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management more
    Helio Health Inc. (04/02/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/199249/case- manager utilization - management ... and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more… more
    Prime Healthcare (03/08/25)
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  • Medical Director Utilization

    AmeriHealth Caritas (Newtown Square, PA)
    …more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director, Utilization Management provides organizational leadership in the ... policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The… more
    AmeriHealth Caritas (04/11/25)
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  • Manager Behavioral Health Services

    Elevance Health (Houston, TX)
    ** Manager Behavioral Health Services** The ideal... Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH ... UM), or Behavioral Health Case Management (BH CM) or a combination of both functions...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
    Elevance Health (04/17/25)
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  • Manager of Behavioral Health…

    Elevance Health (Norfolk, VA)
    …reside and hold licensure in the state of Virginia.** The ** Manager of Behavioral Health - Virginia SED/SMI Case Management ** will be responsible for leading ... a team of behavioral health clinicians and non-licensed support staff to provide SED/SMI Case Management services. Primary duties may include but are not limited… more
    Elevance Health (04/11/25)
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  • Manager II Behavioral Health…

    Elevance Health (Los Angeles, CA)
    …The ** Manager II Behavioral Health Services** will be responsible for Behavioral Health Utilization Management (BH UM), or Behavioral Health ... ** Manager II Behavioral Health Services** **Location:**...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum… more
    Elevance Health (04/16/25)
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