Behavioral Health Utilization Review Specialist
Gosnold
Gosnold is seeking an Utilization Review Specialist to perform pre-certification and concurrent reviews, working closely with clinical teams to coordinate care and ensure patient coverage. The role requires strong communication with Patient Financial Services and meticulous documentation of UR data. Ideal candidates will have a relevant Bachelor's degree and at least two years of clinical experience in health services, with knowledge of levels of care and medical criteria. #J-18808-Ljbffr
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant... ...optimization, compliance, and high-quality patient care across behavioral health services. #J-18808-Ljbffr...SuggestedRemote work
- ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...SuggestedRemote work
- ...About Us FHE Health ("FHE") is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...We are seeking an experienced specialist who is passionate about making... ...preferred. 2-3 years of utilization review experience in behavioral health...SuggestedDaily paidFull timeRemote work
$65k - $88.6k
Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document, and communicate medical services and benefit determinations. The role requires clinical knowledge, independent decision-making, and collaboration...SuggestedRemote job- Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and determinations for medical services and benefit administration. You will interpret criteria and policies and work with providers...SuggestedRemote jobWork at office
- Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document and communicate medical services and benefit determinations. The role requires clinical judgment, strong communication, and independence, with travel...Remote jobFull timeWork at office
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Work at officeRemote work
$69.39k - $88.61k
Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote jobFull time$20 - $30 per hour
...A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...- ...Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House's Mission is "Empowering people to heal and build... ...substance use treatment, medical care, prevention, and mental health services. Odyssey House continues to receive Best of State...Full timeContract workTemporary workCasual workLocal areaImmediate startFlexible hoursShift work
$69.79k
Behavioral Health Specialist Needed Full-time, IMT Position Program/Department Description: Intensive Mobile Treatment (IMT) is an innovative, creative... ..., timely and accurate documentation of all contacts. Utilize public transportation to travel throughout the boroughs....Full timeFlexible hoursWeekend workDay shiftAfternoon shift$17 - $19.4 per hour
...to $19.40 / hour - depending on education Job Summary As a Behavioral Health Specialist within a licensed psychiatric residential treatment... ...dressing, hygiene, social interactions) to promote independence. Utilize de-escalation techniques, active listening skills, and...$76.72k
...operations, pilot projects, and research under one roof. CJA utilizes procedural justice practices to provide pretrial services... ...boroughs of NYC, employing over 300 employees, citywide. BEHAVIORAL HEALTH SPECIALIST INTENSIVE CASE MANAGEMENT QUEENS SUPERVISED RELEASE POSTED...Work from homeFlexible hoursNight shift$37.5 - $54.25 per hour
Bring Your Clinical Expertise to Logan Health’s Utilization Management Team! Our Mission Quality,... ...for a Utilization Management Specialist to join our dedicated team! Our Utilization... ...Management Specialists play a vital role in reviewing admissions across the Logan Health...Full timeImmediate startRemote work10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift$19 - $22 per hour
RCM Intake Specialist - Behavioral Health: Remote GeBBS Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment... ...accurate records for payer audits, internal quality reviews, and revenue cycle reporting. Follow established...Remote jobHourly pay- The Utilization Review Specialist's primary role is the liaison between the hospitals inpatient and ambulatory services and the managed care organizations... ...Setting required. Undergraduate/Bachelor Degree (required) in Human or Health Services (preferred) #J-18808-Ljbffr Samhsa
- ...Athra Systems/Crosstown Mental Health is a dynamic and forward-... ...to offering a wide array of behavioral health services and solutions... ...Behavioral Health Charge Entry Specialist, is responsible for ensuring... ...(EVOB). Quality Assurance: Review and verify insurance claims for...Remote job
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
$25.46 - $31.86 per hour
...Overview Behavioral Health Associates assist social services teams to provide supportive counseling, advocacy, and education to help... ...agencies Participates in related VNS Home Care activities, e.g., utilization review, staff meetings, education programs, etc. Assumes...Temporary workWork experience placementFlexible hours- Discover Vanderbilt Health With eight hospitals and over 180 clinics, we are the region... ...neighbors throughout the region. Organization Utilization Management Job Summary Facilitates... ...initial admission based on utilization review medical necessity criteria. Refers cases...Remote jobTemporary workWork experience placementLive outFlexible hours
$60k
...The Harm Reduction Specialist provides engagement and... ...and alcohol use, sexual health and self-harm, using a... ...individuals engaging in risky behaviors. In addition, the Harm... ..., including reviewing service plans with program... ...and safety hazards, utilizing individualized strategies...Local areaFlexible hoursWeekend workAfternoon shift- ...Summary: The Utilization Specialist will support Preventive Measures’ Georgia behavioral health operations through authorization management and utilization monitoring while... ...through applicable payer portals and systems. Review authorization packets to ensure all required...For contractors
$40 - $45 per hour
...We are currently seeking a Behavior Intervention Specialist to support our two Manhattan Day Programs at... ...are not limited to the following: Reviews psychological assessment on individuals... ...and instructs program staff in utilization of goals, behavior management, interpretation...Full timeMonday to Friday$64.35k
...supervision of BIS leadership, Behavior Intervention Specialists (BISs) perform clinical... ...from multiple sources and utilizes findings to conduct... ...interdisciplinary meetings and case reviews, including scheduled... ...and registration in Mental Health Counseling issued by the New...ReliefMonday to FridayFlexible hoursAfternoon shift- *Develop, monitor, and update behavior modification programs utilizing principles of ABA and aspects of behavior... ...program planning meetings and case reviews to discuss treatment plan goals,... ...collaboration with agency-wide behavioral health services *Perform all other...Flexible hours
$63.65k
...application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Behavioral Health Specialist I IMT BRONX 1 Hourly Full-Time [Ben Elig] PROFESSIONAL Harlem 2090, New York, NY, US 2 days ago Requisition ID: 252...Hourly payFull timeWork at officeRemote workTrial periodMonday to FridayFlexible hoursShift workDay shift- ...Ensora Health is the leading provider of software... ...services for mental and behavioral health therapists, trusted... ...clients. As an RCM Specialist II, you will serve as... ...What You’ll Do Submit, review, correct, and process... ...and customer outcomes. Utilize technology and...Work at office
$25 - $35 per hour
...Behavioral Health SpecialistAre you passionate about helping children and families thrive? Do you have experience working in mental/behavioral... ...6 MonthsWe are looking for dedicated Behavioral Health Specialists to provide individualized support services to youth and families...Part time- Community Healthcare Network is seeking a Full-Time Behavioral Health Screener to join our Behavioral Health treatment team. You will provide... .... The role involves conducting diagnostic assessments, utilizing scoring tools, and maintaining timely documentation. A strong...Full time
$66.95k
...agency working at the forefront of the intersection between behavioral health and involvement in the criminal justice system. Our mission... ...intensive mobile treatment (IMT). Job Title Behavioral Health Specialist Job Summary IMT is a multi-disciplinary team of behavioral...Full timeWork at officeRemote workTrial periodMonday to FridayFlexible hoursShift workDay shift
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