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Utilization Management Clinician Behavioral Health Jobs

Behavioral Health Triage Clinician
By Community Health Network At , Indianapolis
Knowledge of local resources for behavioral health treatment (Preferred)
Experience in crisis triage and risk assessment (Preferred)
1-2 years of experience with mentally ill or chemically dependent populations (Preferred)
4 year/ Bachelor’s degree required (Required)
Both weeks: Sat. and Sun. 7a-7p
Utilization Management - Behavioral Health Clinician
By Yamhill Community Care At , Mcminnville
Computer skills in word processing, database management, and spreadsheet desirable.
Knowledge in areas of: Medicare and Medicaid UM regulations, McKesson InterQual, and Denial Management.
Two (2) years of experience in Acute Clinical Care or Medical Management setting, adult and children.
Identifies members that are high risk or have conditions that may need case or disease management.
Enters and maintains pertinent clinical information in health management system.
Participates in utilization management committees and works on special projects related to utilization management as needed.
Utilization Management Clinical Coordinator - Substance Use And Behavioral Health - Remote For Colorado
By UnitedHealthcare At , Grand Junction, 81502
3+ years of utilization management experience
Provide management of behavioral health services, including crisis assessment and intervention
Administer benefits, review treatment plans, and coordinate transitions between various areas of care
Undergraduate degree or equivalent experience
1+ years of experience with MS Office, including Word, Excel, and Outlook
Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders)
Team Coordinator, Behavioral Health Utilization Review
By Sentara Healthcare At , Norfolk, 23502
Provides educational services to the Utilization Management staff
Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, DMAS protocols, clinical protocols and clinical review requirements
Minimum 1 year experience in Managed Care Setting (MCO)
First line supervisor in the Utilization Management Department
Provides a leadership role in ongoing utilization review competency assessment, needs identification and educational offerings
Requires knowledge of contractual, regulatory and compliance requirements for government payers, self funded and commercial payers
Utilization Review Specialist - Behavioral Health
By Prestige Utilization Management & Billing Solutions At , Remote $35,000 - $40,000 a year
Excellent data entry skills and ability to navigate electronic systems applicable to job functions
Ensure all pre-certifications are completed for inpatient and outpatient services
Work with facilities to ensure documentation requirements are met
Interface with managed care organizations, external reviews, and other payers
2 or more years experience billing UR healthcare industry – in the mental health/addiction field.
Working knowledge of clinical case formulation for substance abuse/mental health treatment.
Outcomes Manager - Utilization Review - Behavioral Health (Remote)
By VIRTUA At , Marlton, 08053, Nj
Appropriate and complete documentation of clinical review and denial management in the case management documentation system and in the billing system.
Position Qualifications Required / Experience Required:
Manages the concurrent denial process by referring to appropriate resource for concurrent and retrospective appeal activity process.
Understands and applies applicable federal and state requirement.
Utilizes Payer specific screening tools as a resource to assist in the determination process regarding level of service and medical necessity.
Consults with Physician Advisor to discuss medical necessity, length of stay, and appropriateness of care issues.
Behavioral Health Clinician Jobs
By Guideline Healthcare At Raleigh, NC, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician - Remote
By Guideline Healthcare At Elyria, OH, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Manager, Behavioral Health Utilization Management
By Point32Health At , Remote
5-8 years post-master’s direct clinical experience, including utilization management in behavioral health or managed care
Provide monthly Care Management report on team(s) performance, metrics, and goal achievement to the Director of Behavioral Health.
Demonstrated understanding and proficiency in the principles, concepts and techniques of managed care and utilization management.
Able to manage ambiguity and change, and lead a team’s effective management of shifting priorities, competing demands, and rapidly changing conditions.
5-8 years of supervisory experience preferred
Experience with Medicare and Medicaid
Associate Director Behavioral Utilization Management - Remote
By Optum At , Detroit, 48202, Mi
Provide direct oversight to a utilization management team, for employees at multiple locations across the country (remote)
3+ years of people management experience (managing direct reports, coaching, training, performance reviews, running team meetings, etc.)
Proven excellent communication, collaboration, team building and relationship management skills
Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
5+ years of experience managing a clinical/operational unit in a broad range of settings
Experience interfacing with providers and solutioning gaps
Utilization Review Specialist - Behavioral Health
By WellBridge Fort Worth At , Fort Worth, 76132, Tx
Coordinate utilization management reviews for all assigned inpatient, partial hospitalization and intensive outpatient program patients.
Coordinates closely with Director of Utilization Management, Nursing and Clinical Services.
Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
Obtains authorizations for services, coordinates peer-to-peer reviews for assigned caseload.
Understands medical necessity criteria and facilitates accurate and timely documentation to support advocacy of services.
Master’s Degree in Social Work, Marriage and Family Therapy or Counseling from an accredited school or BSN, RN
Behavioral Health Clinician Jobs
By Guideline Healthcare At Bloomington, MN, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician Jobs
By Guideline Healthcare At Bentonville, AR, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician Jobs
By Guideline Healthcare At Burnsville, MN, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician - Remote
By Guideline Healthcare At Weirton, WV, United States
Fully Remote Licensed Therapist / Counselor opportunities for part-time or full time. Bonus offered
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician - Remote
By Guideline Healthcare At Huntington Park, CA, United States
High volume of regular client referrals
Therapy focused model with zero administrative work
5-40 hrs per week - You decide your schedule
Perform your work anywhere that has a reliable internet connection
Competitive hourly rate, with bonuses
Behavioral Health Clinician Jobs
By Planned Parenthood of Northern New England At St Johnsbury, VT, United States
Timely and comprehensive documentation; billing and data compliance that meets all federal, state, funder, and PPNNE regulations and requirements
Development and provision of Patient Education content in the health centers, in accordance with PPNNE Medical Standards and Guidelines
Experience providing behavioral health services to individuals with trauma, including PTSD and developmental complex trauma strongly preferred
Strong communication and interpersonal skills
The range of pay for this position is $28.61/hr to 41.69/hr based on years of experience
Access to benefits is available including health, dental and vision coverage, paid time off and a retirement fund.
Behavioral Health Clinician Jobs
By Fremont Counseling Service At Lander, WY, United States

Behavioral Health Clinician (Counselor, Therapist, Social Worker)

Master's Degree in accredited clinical program.Eligibility for licensure/provisional licensure in Wyoming and ability to maintain licensure.

Ak - Behavioral Health Clinician - $ 2548/Wk - 13 Weeks
By Lighthouse Medical Staffing At Sitka, AK, United States

MUST HAVE ACTIVE ALASKA LICENSEMUST HAVE ALL COVID VACCINATIONS AND FLU VACCINATION This position performs psychiatric emergency services for the community of Sitka and for Mount Edgecumbe Medical ...

Ak - Behavioral Health Clinician - $100
By Lighthouse Medical Staffing At Sitka, AK, United States

MUST HAVE ACTIVE ALASKA LICENSEMUST HAVE ALL COVID VACCINATIONS AND FLU VACCINATION This position performs psychiatric emergency services for the community of Sitka and for Mount Edgecumbe Medical ...