Senior Behavioral Health Utilization Review Clinician
Blue Shield of CA
Blue Shield of CA seeks a Senior Behavioral Health Utilization Management Clinician to conduct clinical reviews for mental health and substance use requests. You will ensure compliance with medical necessities and coding accuracy, utilizing BSC guidelines. This role involves a hybrid work model where virtual work is permitted, but office visits will be necessary based on business needs. Candidates need a current CA license and relevant behavioral health experience. #J-18808-Ljbffr
- ...Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced... ...Health Utilization Management Clinician, Senior, will report to the Manager of Behavioral...SeniorFull timeContract workWork at office
$72.8k - $130k
...Stryker Corporation is looking for a BCBA Senior Care Advocate (SCA) in Las Vegas, NV. This pivotal role supports the behavioral health needs of members, conducting utilization management and ensuring compliance with care standards. The ideal candidate will have clinical...SeniorRemote work$43 - $63 per hour
...Job Description Job Description The Utilization Review Nurse plays a key role in evaluating patient admissions to ensure appropriate levels of care, efficient resource utilization, and compliance with third-party payer requirements. This position involves reviewing...SuggestedRelocation package$41 - $64 per hour
...Job Description Job Description Utilization Review Nurse (RN) Location: Las Vegas, NV Job Type: Full-Time Pay: $41 – $64/hr (DOE) We are seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate...SuggestedFull time$15k
...Job Description Job Description The Utilization Review Nurse plays a critical role in assessing patient admissions to ensure appropriate care, resource efficiency, and adherence to third-party payer requirements. This position involves detailed analysis of medical...SuggestedRelocation package$63 per hour
...Job Description Job Description Title: Utilization Review Nurse (RN) Department: Case Management Job Type: Full-Time Facility... ...$63/hour Employer-paid Nevada PERS pension Competitive health & retirement benefits No state income tax in Nevada...Hourly payFull time- ...A healthcare provider is hiring a Utilization Review Nurse for an on-site position in Las Vegas, Nevada. This role involves reviewing patient admissions for medical necessity and ensuring compliance with payer guidelines. Candidates should have an active RN license in...
- ...COMAGINE HEALTH in Nevada seeks a Supervisor, Clinical Review to supervise clinical staff conducting utilization reviews. Ideal candidates will have an active RN licensure in Alabama, with 3+ years of clinical experience and at least 1 year in a supervisory role. Strong...Remote work
- ...Fusion HCR is hiring! Direct Hire – Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care...
- ...of Southern Nevada (UMC) is seeking a Registered Nurse with extensive experience in acute hospital care and Utilization Management. The role involves reviewing patient admissions, analyzing medical charts, and ensuring compliance with third-party payer requirements. The...Daily paid
- ...healthcare organization in Las Vegas is seeking a Registered Nurse to review patient admissions for appropriateness and compliance. The... ...of clinical nursing experience, including three years in Utilization Management. Responsibilities include analyzing medical charts...Relocation packageShift workWeekend work
$40 - $63 per hour
...We are seeking an Utilization Review Nurse for a full time permanent role onsite in Las Vegas, NV. Candidates must be legally authorized to... ...hospital policies and procedures; Joint Commission Accredited Health care Organizations standards, state statutes governing hospital...Hourly payPermanent employmentFull timeWork at officeShift workWeekend work- ...University Medical Center of Southern Nevada is seeking a Registered Nurse for a per diem position focused on Utilization Management. This role involves reviewing patient admissions and ensuring adherence to standards and payer regulations. Candidates must possess a...Daily paid
- ...Nurse (Nurse Practitioner) in Las Vegas, NV. This position entails providing holistic care, leading interdisciplinary teams, and utilizing evidence-based practices to enhance veteran care. Applicants must have at least a master’s level education, current licensure, and...Senior
$40 - $63 per hour
...A healthcare services provider is seeking a full-time Utilization Review Nurse for a permanent onsite role in Las Vegas, NV. The successful candidate will review patient admissions to ensure efficiency and compliance with third-party payer requirements. Requirements include...Hourly payPermanent employmentFull time$40 - $63 per hour
...Job Description Job Description Salary: $40-$63 Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 $63/hour Position Summary Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer...Full timeWork at officeShift workWeekend work$40.39 - $60.96 per hour
...Intermountain Health in Las Vegas is seeking an RN Utilization Management Reviewer I to conduct utilization reviews, ensuring patient-centered care through effective resource management. This role involves collaborating with providers and patients, adhering to regulatory...Hourly payFull time$20k
...part of a nationally recognized health system dedicated to our... ...this role.As a Physician in Senior Primary Care within our Intermountain... ...culture. They reflect the behavior and attitudes that are... ...While HiredScore assists in reviewing applications, all final decisions...SeniorHourly payShift workNight shiftWeekend work$260k
...part of a nationally recognized health system dedicated to our... ...role. As a Physician in Senior Primary Care within our Intermountain... ...culture. They reflect the behavior and attitudes that are... ...While HiredScore assists in reviewing applications, all final decisions...SeniorHourly payRelocationShift workWeekend work$200k
...Services program office after review of the EDRP application.... ...by VA Insurance: Federal health/vision/dental/term life/long-... ...aligned under the Outpatient Behavioral Health Interdisciplinary Program... ...REAL ID compliant cannot be utilized as an acceptable form of identification...Full timeContract workPart timeFreelanceInternshipSeasonal workWork at officeLocal area- ...academic medical center in Nevada is seeking a Registered Nurse with extensive experience in Utilisation Management. The role involves reviewing patient admissions and ensuring compliance with care standards. Candidates should possess a valid nursing license and a minimum of...
- The US Department of Veterans Affairs in Las Vegas is hiring for a psychologist position that requires a doctoral degree in psychology and a full, unrestricted license. The role demands at least three years of professional experience, proven organizational and communication...Senior
$62.4k - $96.08k
...corporate, NYS Department of Health (DOH), Centers for Medicaid &... ..., coach, coordinate care and review treatment options, through collaboration... ...– Level I Handles behavioral health member clinical management... .... Examples may include Utilization Management, Quality, Behavioral...Work at officeFlexible hours- ...UnitedHealthcare is seeking a BCBA Senior Care Advocate to support behavioral health needs. This remote role involves conducting reviews and managing treatment plans for members with Autism Spectrum Disorder. Candidates should have 3+ years of clinical experience and a...SeniorRemote work
- ...Responsibilities include scheduling, training, and performance reviews of staff. Candidates must be a graduate from an accredited nursing... ...competitive compensation, generous paid time off, and comprehensive health benefits. #J-18808-Ljbffr Universal Hospital Services Inc.Senior
- ...divh2Physician In Senior Primary Care/h2pWhen you join us, youll become a part of a nationally recognized health system dedicated to our mission of helping people live the healthiest... ...core to our culture. They reflect the behavior and attitudes that are important to us,...SeniorHourly pay
$62.7k - $100.4k
...CareSource is seeking a Clinical Care Reviewer II in Las Vegas, NV, responsible for processing medical necessity reviews and coordination... ...members. Key functions include conducting reviews on various health services and collaborating with care partners to ensure proper...$250.24k - $428.98k
...Behavioral Health Medical Director- Child Psychiatrist Location: This role enables associates... ...responsible for completing medical necessity reviews for general child psychiatry cases as... ...clinical knowledge and skills to utilization review processes. Adheres to medical policies...Full timeTemporary workWork experience placementWork at officeLocal areaMonday to Friday1 day per week$19.87 - $28.31 per hour
...PM) Unit/Location Buffalo Senior Primary Care Clinic Additional Details: Please review Minimum Qualifications listed... ...Medical Assistant at Intermountain Health, you will play a vital role in... ...: Under the direction of the Clinician, providing care to patients by...SeniorHourly payFull timeWork experience placementMonday to FridayShift work$19.87 - $28.31 per hour
...PM)/ph3Unit/Location/h3pBuffalo Senior Primary Care Clinic/ppAdditional Details: Please review Minimum Qualifications listed... ...Medical Assistant at Intermountain Health, you will play a vital role in... ...: Under the direction of the Clinician, providing care to patients by...SeniorHourly payFull timeWork experience placementMonday to Friday
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