- Kepro (Richmond, VA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (part-time) to join our growing ... team. Job Summary: Our Behavioral Health Utilization Management Clinical Reviewer will use clinical expertise to review medical records against… more
- CVS Health (Salt Lake City, UT)
- …Time (PST), or Arizona time zones. As a UM Clinician Behavioral Health you will: - Utilize clinical experience and skills in a collaborative process to ... utilization/benefit management function. Required Qualifications - Valid unrestricted independent professional behavioral health clinical license to practice… more
- CVS Health (Tallahassee, FL)
- …thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical ... years clinical practice experience, eg, psychiatric hospital, residential or behavioral health treatment setting. 1+ year Electronic Medical Record… more
- Molina Healthcare (Dallas, TX)
- …management or utilization management in managed care, medical or behavioral health settings. + Two years of clinical auditing/review experience. To all ... + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case...UM ), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors… more
- Universal Health Services (Memphis, TN)
- Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those seeking to be part of a team-oriented and compassionate ... paid time off. Since 1969, Lakeside has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and Mid-South… more
- Elevance Health (Louisville, KY)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Atlanta, GA)
- …locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Rancho Cordova, CA)
- …The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Elevance Health (Cerritos, CA)
- …training, or as otherwise required by managers. **Shift:** **M-F; 8:30am-5:00pm** Responsible for Behavioral Health Utilization Management (BH UM ), or ... of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. +...clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. + Additional… more
- Corewell Health (Grand Rapids, MI)
- … Manager provides clinical and operational management over all behavioral health programming and services delivered to the organization's membership ... objectives. + Plan and direct all Quality, UM and Clinical regulatory functions of the Behavioral Health department in order to maintain regulatory and… more
- Elevance Health (Rocky Hill, CT)
- ** Behavioral Health Care Manager II** **This...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers ... - Friday 8:30 am to 5 pm EST.** The Behavioral Health Care Manager II is responsible...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health … more
- Elevance Health (Seven Fields, PA)
- …Point office. **Hours:** Monday-Friday 8:00 am -5:00 pm Eastern Standard Time The Behavioral Health Care Manager II is responsible for managing psychiatric and ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Rocky Hill, CT)
- …quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... Requires MA/MS in social work counseling or a related behavioral health field or a degree in...LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health … more
- Elevance Health (Rocky Hill, CT)
- …Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental health and substance use ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Latham, NY)
- …locations. **Hours:** Monday-Friday 8:00 am -5:30 pm Eastern Standard Time The Behavioral Health Care Manager II is responsible for managing psychiatric ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Elevance Health (Indianapolis, IN)
- …the hired candidate may be asked to work in office as needed.** The ** Behavioral Health Care Manager I** - **Indiana** is responsible for managing psychiatric ... healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers...Requires MA/MS in social work counseling or a related behavioral health field or a degree in… more
- Molina Healthcare (Albuquerque, NM)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- CVS Health (Richmond, VA)
- …Greensville, Nottoway. Up to 25% of expected travel. Standard business hours: Monday-Friday. The Behavioral Health Clinical Liaison is a clinical leader ... - Consults with Plan executive management regarding physical and behavioral health clinical issues as...clinical issues as they relate to medical management ( UM , CM, DM) provider and system of care issues,… more
- LA Care Health Plan (Los Angeles, CA)
- …Management ( UM ), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health , Community Health , Health Education, as well ... Enhanced Care Management Clinical Specialist II Job Category: Clinical ...analyze the most complex cases involving highly acute physical health , behavioral health , complex/catastrophic and/or… more
- AmeriHealth Caritas (Newtown Square, PA)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate...As part of the Utilization Management Administrative team, the UM Administrative and Operations Program Specialist is responsible for… more