Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer... to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management...
Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non... in behavioral health and/or substance use disorder. Managed care and utilization management experience required. Licensure: RN...
Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer... to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management...
management and specialty pharmacy services, behavioral health services, and other administrative services. Discover... assessment knowledge and health care/social services licensure experience, the Reviewer reviews the Service Coordinator...
about making a meaningful impact in both clinical and behavioral health? Our department stands out for its innovative, patient...-centered approach and unwavering commitment to compassionate care. We are currently seeking a dedicated Utilization Reviewer...
about making a meaningful impact in both clinical and behavioral health? Our department stands out for its innovative, patient...-centered approach and unwavering commitment to compassionate care. We are currently seeking a dedicated Utilization Reviewer...
to our healthcare services, we offer comprehensive behavioral health services on the hospital campus and Bayview campus in Chula Vista..., TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology...
role The Behavioral Health Utilization Management Clinician provides utilization management for all behavioral health...; within the designated time frames indicated. The Behavioral Health Utilization Management Clinician also partners with providers...
-certification, concurrent review, and appeals of Behavioral Health OP services. Mentors Behavioral Health Care Management staff.... How you will make an impact: Partners with internal UR staff and external Behavioral Health Providers to ensure appropriate...
, per contract requirements. 3+ years of clinical experience in an acute, behavioral health, and/or med-surgical environment. 2...+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization. 2+ years of knowledge of medical necessity...
) Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given... clinical input and oversight related to outpatient services Conduct peer reviews with psychologists, behavioral health...
Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh... for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria...
. Identify and refer members with specific medical and/or behavioral health needs or complex case management and collaborate... of medical records. Refer cases to Integrated Health Management, Pharmacy Department or Benefits Integrity Department depending...
Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh... who is passionate about delivering high-quality, evidence-based behavioral health care. The ideal candidate will hold...
Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh... for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria...
needs of the patients using the functions of Utilization Resource Management, Transition of Care, Discharge Planning..., health care team, payors, and providers to achieve appropriate resource management to implement safe discharge plan of care...
Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh... for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria...
Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh... for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria...
effectively with Utilization Management Staff, providers, other internal and external customers and management. Route Cases Based... This job performs accurate and timely processing of pre-certification requests for authorization of medically necessary health care...
physician reviewer assignments for medical management decisions. Cases requiring physician review are provider and member...), Utilization Review Accreditation Committee (URAC), Pennsylvania Department of Health, Department of Labor, the Center for Medicare...