- CVS Health (Tallahassee, FL)
- …**_Must reside in state of Florida, position is 100% remote._** Behavior Analysis Utilization Management Clinical Consultant applies critical thinking ... clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to Behavior Analysis . Utilizes clinical… more
- AdventHealth (Glendale Heights, IL)
- …health care services regarding admissions, case management , discharge planning and utilization review for Behavioral Health **The value you'll bring to the ... Oversees and coordinates compliance to federally mandated and third-party payer utilization management rules and regulations. Qualifications **The expertise and… more
- Elevance Health (Norfolk, VA)
- …PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Intermountain Health (Murray, UT)
- …barriers to success at home.** **Essential Functions** + Utilization and Care Management of members with Autism or other Behavioral Health conditions. + ... provider locations within Select Health region. ** Utilization Review and Care Management :** + **Review and Analysis :** + Review medical records to determine… more
- Beth Israel Lahey Health (Burlington, MA)
- …difference in people's lives.** This position is on-site. **Job Description:** The Utilization Analyst works with physicians, the payers and inpatient case ... management team to validate the medical necessity of the...necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these… more
- Centene Corporation (Tallahassee, FL)
- …Purpose:** Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. ... Evaluates member's care and health status before, during, and after provision of Applied Behavioral Analysis (ABA) services to ensure level of care and services… more
- US Tech Solutions (Columbia, SC)
- …stable service from your internet provider (non-satellite). + Skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals + Please list any 'soft skills'… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/ analysis , ... mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years… more
- UPMC (Moosic, PA)
- …consultation with practitioners in the field. This includes significant responsibility for quality management and utilization management and for assuring the ... you will assure the quality and efficiency of the behavioral health care delivered to Community Care members. Incorporated...protocols. + Review the medical aspects of cost and utilization reports generated by Medical Management Information… more
- CVS Health (Trenton, NJ)
- …role requires experience and familiarity with Substance Use Disorder (SUDS), Applied Behavioral Analysis (ABA), Trauma Informed Care, Person Centered services, ... the plan and works across various departments including Care Management , Utilization Management , Quality ... Management , Quality Management , and Medical Management on issues related to Behavioral Health.… more