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- ...behavioral health and substance abuse case management through utilization reviews and care coordination. While not a member facing role, you'll... ...field ~ Active independent AZ license (LCSW, LMFT, or LPC) ~2+ years of behavioral health experience ~ AZ residency...LpcRemote workMonday to Friday
Optum
Tucson, AZ4 days ago - ...Utilization Management Specialist Proactively monitor utilization of services for patients... ...professional clinical staff. Conduct reviews in accordance with certification requirements... ...Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility...LpcWork at office
$27.02 - $48.55 per hour
...flexibility. Position Purpose Performs a clinical review and assesses care related to mental... ...data to improve quality and appropriate utilization of services Provides education to... ...contract requirements e.g., LCSW, LMHC, LPC, LMFT, LMHP and RN with BH experience Strong...LpcHourly payFull timeContract workPart timeWork at officeRemote workFlexible hoursCentene Corporation
California, MO1 day ago- About the job Utilization Review Specialist Join Our Team: As a Utilization Review Specialist, you will play a pivotal role in managing and performing... ...culture Opportunities for career advancement LMSW, LMHC, LPC, or other healthcare-related credentials or experience...Lpc
- ...the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews.... ...unencumbered professional licensure/independent licensure in Ohio: LPC, LCSW, LICSW, LISW, LCMHC, LMFT Must have ability to...LpcWork at officeRemote workMonday to FridayFlexible hoursWeekend work
AmeriHealth Caritas
Newtown Square, PA3 days ago - ...Utilization Management Coordinator Via Linda Behavioral Hospital is a behavioral health... ...with managed care organizations, external reviewers, and other payors for initial reviews, continued... ...Nurse or licensed as an LMSW, LCSW, LPC, MFT or similar AZ Board of Behavioral...LpcWork at officeLocal area
- Overview The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible... ...required; advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred. Excellent organizational, communication...LpcWork at officeLocal area
- ...Utilization Review Coordinator This is a PRN position About Company: We're officially a Great Place To Work! We've always believed that... ...chemical dependency setting. Licensure: Current RN, LCSW, or LPC license preferred. Skills and Competencies: In-depth...LpcFull timePart timeReliefWeekend work
- ...Utilization Management Specialist Must be licensed RN or Social Worker in CT Position Purpose... ...is responsible for acute care concurrent review authorizations, denials tracking &... ...level Licensed professional (LCSW, LMFT, LPC) or RN (Masters not required) State of...LpcDaily paidLocal areaWork from home
Trinity Health
Waterbury, CT9 days ago $40 per hour
...Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone... ...seeking a Utilization Management Nurse to review provider-submitted service authorization... ...~ Active, unrestricted RN, LPN, LCSW, or LPC license Required Education and Experience...LpcHourly payPermanent employmentTemporary workWork at officeRemote workMorgan Stephens
United States3 days ago$33 - $38 per hour
Overview Serenity Knolls is seeking a Full Time On‑Site Utilization Review Specialist at our substance use facility. Proactively monitor utilization... .../CERTIFICATIONS: Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC‑I within the state where the facility provides services;...LpcHourly payFull timeWork at office- ...Job Title Reviews planned, in process, or completed health care services to ensure medical... ...in Care Coordination team and utilization management activities, including collaboration... ...LMHP - Licensed Mental Health Professional LPC - Licensed Professional Counselor LMFT -...Lpc
Saviance
Saint Louis, MO3 days ago - Harboroaks in Riverside, CA, seeks a Utilization Review (UR) Specialist for their inpatient psychiatric facility. You will monitor service utilization... ...experience and preferred licenses (LPN, RN, LMSW, LCSW, LPC). Benefits include flexible scheduling, competitive pay, and...LpcFlexible hours
- ...guidelines Required Previous experience in Utilization Management and/or Appeals Required... ...authorization process Required Utilization Review or Care Management experience Preferred... ...LCSW, in the state of Georgia. Required or LPC/LMFT also acceptable Required Additional...LpcWork experience placementRelief
- ...Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for Substance Abuse Sentara Health Plans is hiring a Behavioral Health Utilization... ...Utilization Management clinician is responsible for review of clinical information received from providers ensuring...LpcRemote jobPermanent employmentFull timeFlexible hoursShift workWeekend workDay shift
- ...Utilization Management Professional Client: Magellan Health Job Location: FL Job Duration... ...to the company P&P's procedures. Reviews planned, in process, or completed health... ...LMHP - Licensed Mental Health Professional, LPC - Licensed Professional Counselor, LMFT -...Lpc
Saviance
Pensacola, FL2 days ago $26.41 - $51.49 per hour
...Provides support for member clinical service review processes specific to behavioral health.... ...Molina care model. • Adheres to utilization management (UM) policies and procedures.... ...(LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor...LpcHourly payFull timeWork experience placementWork at officeMolina Healthcare
Saint Petersburg, FL13 hours ago- ...Utilization Management Case Manager Havenwyck Hospital (a UHS facility) is a Joint Commission... ...admission and continues stay record reviews with external payers, utilizing approved... ...fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.). A minimum of 2 years of post...LpcLocal area
Alan B. Miller Medical Center
Auburn Hills, MI3 days ago - ...8a-5p Additional Information: The Utilization Manager improves overall quality of clinical... ...medically necessary and timely. RN or LPC Required Masters Degree Required 3... ...concurrent and retrospective medical record reviews to ensure services are appropriate,...LpcFull timeWork experience placementLocal areaShift workDay shift
Arkansas Children's Hospital
Little Rock, AR3 days ago $26.41 - $51.49 per hour
...Provides support for member clinical service review processes specific to behavioral health.... ...to promote Molina care model. Adheres to utilization management (UM) policies and procedures.... ...(LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical...LpcHourly payWork experience placementWork at office- ...based in Alabama. The Supervisor, Clinical Review plays a critical role in providing... ...supervision of clinical staff who conduct utilization review and/or specialty reviews. The Clinical... .... Preferred Qualifications LCSW, LPC licensure or equivalent clinical certification...LpcContract work
$54.1k - $116.76k
...This is an authorization/precertification (utilization management) role focused on behavioral... ...The Behavioral Health Precert/UM clinician reviews incoming authorization/Precert requests... ...state of residence (e.g., LMSW, LCSW, LISW, LPC, or comparable), or Registered Nurse...LpcHourly payFull timeTemporary workLocal areaCVS Health
Salt Lake City, UT1 day ago$26.41 - $51.49 per hour
Molina Healthcare is seeking a professional in Jacksonville, Florida, to provide support for member clinical service review processes specifically in behavioral health. This role ensures that services are medically necessary while adhering to established guidelines and...LpcHourly payMolina Healthcare
Jacksonville, FL4 days ago- ...Employment Type: Full time Shift: Day Shift Description: Full Time Day Shift 40 hours weekly Position Purpose: The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior...16 hoursFull timeContract workWork at officeLocal areaShift workNight shiftDay shift
Trinity Health
Mason City, IA3 days ago - ...Join Our Team as an RN - Case Manager/Utilization Review/Clinical Documentation Specialist Are you a dedicated registered nurse passionate about optimizing patient care and healthcare delivery? We are seeking a motivated and skilled RN-Case Manager/Utilization Review...Day shift
VieMed
Syracuse, NY2 days ago $31 - $50 per hour
...PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement... ...professional clinical staff. Conduct reviews, in accordance with certification... ...Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility...LpcHourly payFull timeTemporary workWork at officeLocal area- ...Utilization Review Nurse (RN) A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its...Work experience placement
Careers Integrated Resources Inc
Raleigh, NC3 days ago - Community Health Network is seeking a Supervisor Utilization Review in Indianapolis, Indiana. This role is responsible for managing daily operations, overseeing workflows, and leading a high-performing team. Candidates should have at least 3 years of experience in Utilization...
- ...the right time? In this role, you will review clinical documentation to determine medical... ...system; apply evidence‑based criteria to utilization management reviews; document clinical... ...behavioral health licensure such as LCSW, LPC, LCPC, LPA, PsyD, PhD) Master’s in physical...LpcFull timeContract workRemote workWork from home
$72k - $115k
...ramp up What we offer Therapists (LCSW, LPC, LMFT) ~ Flexible work schedules ~... ...only use or . Additionally, our recruiters utilize email addresses with the @lifestance.com... ...to this email address as they will not be reviewed or responded to. To apply for a position,...LpcFull timeWork at officeRelocation packageFlexible hoursLifeStance Health
Broomfield, CO13 hours ago
