Hours of Work : 40 Days Of Week : 5 Work Shift : Job Description : Job Purpose The Surgical Clinical Reviewer... services at Methodist Richardson Medical Center – Campus for Continuing Care, which include a behavioral health and addiction...
. This detailed clinical judgment includes evaluating whether the requested service is a covered benefit under the member's health.... Identify and refer members with specific medical and/or behavioral health needs or complex case management and collaborate...
Role Overview: The Clinical Appeals Reviewer is responsible for processing appeals and ensuring all milestones... services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas...
Research Investigator II - Behavioral & Mental Health Research Investigator II - Behavioral & Mental Health will work... expertise and funding in Behavioral and Mental Health. This includes a background in mental health services research...
: Minimum of 2 years’ experience in a Behavioral Health/Clinical setting preferred. ABA experience preferred... with internal UR staff and external Behavioral Health Providers to ensure appropriate and consistent utilization of plan benefits...
, and experiences: Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred. Experience with psychological... with internal UR staff and external Behavioral Health Providers to ensure appropriate and consistent utilization of plan benefits...
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical... prior authorization, continued stay, retroactive and retrospective reviews for Inpatient and Outpatient Behavioral Health...
is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental Health Resource Center (MHRC... corporation that provides a wide range of mental health and behavioral health care services to the community such as 24-hour...
clinical reviews for outpatient behavioral health services, including: Applied Behavior Analysis (ABA), psychological... Commitment to clinical excellence and meaningful impact Position Purpose: Authorize, direct and monitor care for behavioral...
Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical... and ensure high-quality, evidence-based behavioral health care. Why Join Us? 100% remote flexibility Meaningful work...
are escalated to the Medical Director for further review. The reviewer independently applies medical and behavioral health... based on clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness...
Medical Director for further review. The reviewer independently applies medical and behavioral health guidelines to authorize... based on clinical criteria. Using professional judgment, the reviewer assesses the appropriateness of services, identifies...
Director for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services... criteria. Using professional judgment, the Clinical Care Reviewer assesses the appropriateness of services, identifies care...
We are recruiting for a motivated RN Clinical Trainer/Auditor - Denver Health Medical Plan (Must Be a Colorado Resident... is responsible for developing, delivering, monitoring and maintaining a variety of clinical training programs for the Health Services...
of Illinois. Position Overview The Division of Behavioral Health and Recovery is seeking to hire a clinical psychologist... as an expert witness in accordance with Mental Health Code and Forensic statutes. Essential Functions Serves as a clinical...
of Illinois. Position Overview The Division of Behavioral Health and Recovery is seeking to hire a clinical psychologist... as an expert witness in accordance with Mental Health Code and Forensic statutes. Essential Functions Serves as a clinical...
compliance with all clinical and operational regulatory requirements from Alameda County Behavioral Health Department, State..., within required timeframes. Sits on the CQRT team as a chart reviewer and works with QI to develop best practices. Serve as the clinical...
. Collaborate with Clinical Director and Lead Behavioral Health Tech to approve all clinical passes for clients in community housing... level of care. Collaborate with Clinical Director and Lead Behavioral Health Tech to approve phone calls for clients...
Job Description: Utilization Management Representative II A proud member of the Elevance Health family of companies, Carelon Behavioral Health..., formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive...
health’ model of care, Essen has five integrated clinical divisions offering services in primary & specialty offices, urgent... with Behavioral Health and/or Substance abuse required. Prior supervisory experience required. At least 3 years previous managed...