- AmeriHealth Caritas (Charleston, SC)
- …us at www.amerihealthcaritas.com . **Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is ... pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services....+ Minimum of 2 years of behavioral health and substance use disorder experience.; + Utilization… more
- CVS Health (Frankfort, KY)
- …/benefit management program. **Required Qualifications** + Licensed independent behavioral health clinician with Kentucky state licensure (LCSW, LPCC, ... **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a...States. The requirements is for candidates to hold a Behavioral health clinician or Registered Nursing with… more
- Centene Corporation (Phoenix, AZ)
- …appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors behavioral health (BH) utilization ... Arizona for this remote position.** **Position Purpose:** Supervises the behavioral health (BH) utilization review...performance, quality, and efficiency standards + Works with BH utilization management team to resolve complex BH… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Humana (Jefferson City, MO)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Tufts Medicine (Malden, MA)
- …strategic plan, ensuring integration with Tufts Medicine's overall behavioral health strategy. + Oversee clinical resource management , utilization ... and prescribe medications and treatments. + Assist in the management of behavioral or mental health...You have a strong understanding of behavioral health regulations, quality improvement methodologies, and risk management… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health , Pharmacy, Registered ... Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health , Respiratory Therapy, Registered Dietitian, Registered Nurse,… more
- CVS Health (Tallahassee, FL)
- … Health of Florida** is searching for a **Senior Manager of Regulatory Behavioral Health Services & Utilization Requirements** with a strong understanding ... of the Florida behavioral health provider and services landscape with...successful in this role if you successfully drive greater utilization of both SBIRT and MAT - that is,… more
- Centene Corporation (Austin, TX)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... licensure as outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review… more
- Elevance Health (St. Rose, LA)
- …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 ... studies including, but not limited to the development and implementation of behavioral health outcomes improvement interventions such as newsletter article,… more