Senior Behavioral Health Utilization Review Clinician
Blue Shield of CA
Blue Shield of CA is seeking a Behavioral Health Utilization Management Clinician, Senior, to conduct clinical reviews of mental health and substance use authorization requests across levels of care. This role supports medical necessity, coding accuracy, and policy compliance using established guidelines. You will join a Hybrid Virtual Work model, with occasional office visits based on business needs. A CA license (LCSW/LMFT/LPCC/PhD-PsyD or an RN with BH experience) and 5 years of relevant #J-18808-Ljbffr Blue Shield of CA
- Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced... ...Behavioral Health Utilization Management Clinician, Senior, will report to the Manager of...SeniorFull timeContract workWork at office
- ...Your Role The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements...SeniorFull timeWork at office
- ...Job Title Utilization Management Team Leader Job Description The Utilization Management... ...utilization and retrospective clinical reviews across multiple lines of business,... ...subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services...SeniorFull timeContract workPart timeWork at officeLocal areaWork from homeHome officeWeekend workAfternoon shift2 days per week
- ...Grievances team is responsible for clinically reviewing member appeals and grievances that are... ...denial. The Appeals and Grievances RN Senior will report to the Manager of the... ...second level appeal reviews for members utilizing Evidence of Coverage, BSC evidenced based...SeniorFull timeWork at officeMonday to FridayShift work
- ...member treatment plans and care continuity Evaluate member health behaviors, cultural influences, and belief systems to identify barriers... ...needs, and requirements are subject to change with periodic reviews. Physical Requirements: Office Environment - roles involving...SeniorFull timeContract workPart timeWork at officeLocal areaWork from homeHome officeAfternoon shift2 days per week
- ...IN THE SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCY... ...CALIFORNIA BOARD OF BEHAVIORAL SCIENCE EXAMINERS RESPONSES... ..., specifically the Utilization Management and Quality... ..., service utilization review, medication monitoring... .... Mental Health Clinician II applicants should have...Hourly payContract workWork at officeLocal area
- ...Mental Health Clinician II – Utilization Management & Quality Assurance Unit Shasta County, Health and Human... ...is organized into four branches: Behavioral Health & Social Services, Public Health... ...chart auditing, service utilization review, medication monitoring,...Hourly payWork at officeLocal area
$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed... ...opportunity with Yoh’s managed care health plan client based out of Redding or Fairfield... ...setting. The UM RN Nurse Coordinator reviews outpatient authorization requests,...Contract workTemporary workRemote workMonday to FridayWeekend work- ...Life connects adults 65+ with licensed clinicians for behavioral health, geriatric care and longevity... ...management, cognitive health, medication review and weight management, organized around... ...to lead longevity days at our partner senior living communities. Each day opens...SeniorContract workFor contractorsFlexible hoursWeekday work
- ...Demonstrated competence in care management functions and standards of practice ~ Knowledge of community resources, treatment options, home health services, funding sources, and specialty programs ~ Working knowledge of regulatory and accreditation standards including CMS,...SeniorFull timeContract workWork at officeAfternoon shift
- ...PPNorCal)is seeking an Advanced Practice Clinician for our Redding Health Center. The position is full-time, 32... ...APPLICATION INSTRUCTIONS: After review of your application, resume and qualifications... ...-based practice protocols. Utilize knowledge of and experience in...Hourly payFull timeWork at officeLocal areaRelocation
- ...provide comprehensive mental health care to patients in a correctional... .... Conduct regular medication reviews to assess efficacy, side... ...suicidal ideation, and aggressive behaviors. ~ Offer individual and group psychotherapy sessions, utilizing evidence-based therapeutic...16 hoursPart timeImmediate start
- ..., monitor and treat patients in critical care situations. Utilize critical thinking skills to manage the critically ill or injured... ...options at GlobalMedicalResponse.com/Careers. GMR's Core Behaviors -keep care at the center, raise your hand, seek to understand,...Immediate startRelocationShift work
- ...patient care in an occupational health setting. As a key member of... ...visit times. Supervising clinicians and support staff, ensuring compliance... ..., and patient safety. Utilizing clinical systems for... ...regulations. Proficiency in reviewing clinical work and supervising...Weekend work
$40 - $45 per hour
...established protocols. Verify patient identity, review medical history, and explain procedures... ...safety standards and ALARA principles Utilize protective devices and safe practices to... ..., Arizona. We specialize in ensuring the health and well-being of workers through a range...Hourly payMonday to FridayNight shiftWeekend work- ...Nurse (RN) will also educate patients on health conditions, monitor their progress, and... ...physical assessments and history reviews to determine patient health status and prioritize... ...eager to make a difference. LPN, RN, Behavioral Health, Practitioner, and other opportunities...Temporary workLocal areaFlexible hoursNight shift
$75 - $80 per hour
...Senior Project Scheduler JOB-10047628 Anticipated... ...industries and for Health purposes. Oxygen,... ...Schedule Execution Plan Utilize REX analysis and... ...(Invitation to Bid) Review subcontractor schedules... ..., influence, and drive behavior change without formal authority...SeniorFull timeContract workTemporary workWork experience placementFor subcontractorWork at officeLocal areaFlexible hours$38 - $44 per hour
...Registered Nurse (RN) Are you looking for a meaningful role in behavioral health and have the desire to work with an organization that puts... ...Pursuant to the California Consumer Privacy Act (CCPA), please review this link to provide information on how we collect and use...Full timeLocal area$250k - $300k
...expedite case closure Manages clinicians and support staff and... ...systems evaluation, and human behavior Customer and personal service... ...to be audited, observed, and reviewed; is positively responsive to... ...We specialize in ensuring the health and well-being of workers through...Full timeWork at officeMonday to FridayNight shiftWeekend work$125k
...elevate your career to new heights? PHI Health is looking for dynamic, driven individuals... ...by attending mandatory meetings, chart reviews, equipment reviews, skill labs, clinical... ..., our communities and each other. Behavioral Competencies Drive - The ability to maintain...Hourly payLocal areaRelocation packageShift work$43 - $53 per hour
...Home Health Care Management Home & Health Care Management is... ...following duties successfully: Review of medical records including... ...clients' care needs. Utilize electronic health record as required... ...Professional behavior when on duty Discharge planning...Full timeWork experience placementWork at officeMonday to Friday$2,500 per week
...weeks in Redding, California. Vivian Health provides transparent Travel Physical... ...Therapist Salary information and unbiased reviews from leading Travel Therapy Agencies... ...Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol...Weekly payLong term contractPermanent employmentTemporary workWork at officeShift work$20 - $30 per hour
...Location: Reading, MA Join a leading clinician-led behavioral health company today! OptiMindHealth (OMH)... ...offerings and needs to stakeholders, review our specialty areas and note our... ...seek ways to increase service line utilization and cross-selling opportunities for...Part timeTraineeshipWork at officeFlexible hoursNight shift- ...APPLY TODAY ! The Psychiatric Mental Health Nurse Practitioner (PMHNP) provides high... ...suicidal ideation or self-injurious behaviors. ~ Collaborate closely with behavioral... ...treatment planning conferences, and case reviews. ~ Document promptly and properly....Part time
$48 - $54 per hour
...Equipment and Technology Annual Performance Reviews with performance-based increases... ...with your core strengths as a therapist. Utilize AgeRight Therapy's evidence-based clinical... ...highly motivated patients, many of them seniors, helping them achieve therapy goals and a...- ...Home Health NurseUnit Notes Unit - Home Health "Mileage will not be paid. This is an all-inclusive bill rate***" Required Certifications... ...antibiotics with PICC line care, labs. Additional Job Duties/Utilization Review involved? No UR required. These positions will be direct...Interim roleMonday to FridayShift work
$55 - $65 per hour
...Equipment and Technology Annual Performance Reviews with performance-based increases... ...with your core strengths as a therapist. Utilize AgeRight Therapy's evidence-based clinical... ...highly motivated patients, many of them seniors, helping them achieve therapy goals and a...$50 - $60 per hour
...Equipment and Technology Annual Performance Reviews with performance-based increases... ...with your core strengths as a therapist. Utilize AgeRight Therapy's evidence-based clinical... ...highly motivated patients, many of them seniors, helping them achieve therapy goals and a...$400k
...thriving integrated practice with high pathology patients, and co-managing optometrists. Seeking a cataract surgeon with desire to utilize progressive technologies including femtosecond laser assisted cataract surgery, ATIOL, etc. Proven top tier income with group...Full timeImmediate startRelocation packageFlexible hours$72k - $79k
...Description: Under the supervision of a licensed clinician The Associate Clinician position is... ...adjustments, and seeking general mental health services. The ideal candidate should... ...as outlined Actively participate in behavioral health team meetings, clinical discussions...Full timeWork at officeLocal areaAfternoon shift
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