As a Behavioral Health Utilization Management Clinician at Cambia Health Solutions, Inc., you will be part of a team dedicated to providing utilization management services to meet members' specific healthcare needs, promoting quality and cost-effective outcomes. This role involves performing comprehensive utilization management reviews, ensuring adherence to medical necessity and policy standards, and fostering collaboration with interdisciplinary teams. The position offers the opportunity to work from home within Oregon, Washington, Idaho, or Utah, making it ideal for licensed Clinicians with a passion for Utilization Management looking to make a career change.

Behavioral Health Utilization Management Clinician

The Behavioral Health Therapist is a member of an interdisciplinary team at Kaiser providing direct assessment, diagnosis formulation, treatment planning, treatment intervention, and psycho-education to members and/or family members. They must be familiar with all aspects of psychopathology and recognize the appropriate clinical treatment intervention needed. The role involves working with specific age groups based on training and certificate, and requires expertise in a variety of treatment modalities.

Behavioral Health Therapist - LCSW, LPCC, LMFT

Behavioral Health Therapist

The Behavioral Health Care Manager at PerformCare Pennsylvania is a key member of the collaborative care team, responsible for utilization management, case and care management, and coordinating behavioral health care for members. This role involves working closely with members, their families, behavioral health providers, and medical providers to ensure comprehensive and quality care. The position is remote and requires a Master's Degree in Social Work, Mental Health Counseling, Psychology, or Nursing, along with a relevant Pennsylvania license.

Behavioral Health Care Manager--PerformCare Pennsylvania

Behavioral Health Care Manager

Guideline Healthcare is offering fully remote licensed Therapist / Counselor opportunities, ideal for both full-time and supplemental work. This role focuses on therapy without administrative work, allowing for a flexible schedule with 5-40 hours per week. Therapists will perform their work remotely, as long as they have a reliable internet connection, and will be compensated weekly with a potential first client bonus and a $650 monthly health stipend.

Behavioral Health Counselor - Telehealth

Behavioral Health Counselor

The Clinical Case Manager Behavioral Health at CVS Health is responsible for utilizing advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services. This role aims to promote effective utilization of available resources and optimal, cost-effective outcomes. The position is fully remote in the USA, with standard business hours Monday to Friday, no weekends or holidays.

Clinical Case Manager Behavioral Health DSNP-Spanish Speaking

Clinical Case Manager Behavioral Health

The Behavioral Health Case Manager at Molina Healthcare will work remotely to support the Medicaid Behavioral health population, requiring excellent computer skills and attention to detail. This role involves multitasking between systems, talking with members on the phone, and entering accurate contact notes in a fast-paced environment. Local travel to the office in Troy, MI, for team meetings or trainings may be required.

Case Manager - (SUD)

Behavioral Health Case Manager

The Field-Based Remote Behavioral Health Case Worker at AmeriHealth Caritas is responsible for managing and coordinating care, services, and social determinants of health for members with behavioral health conditions and acute, chronic, and medically complex needs. This role serves as the primary point of contact for the care team, utilizing strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care, and barriers to care. The position involves developing care plans, supporting members during transitions of care, reviewing medication lists, and maintaining accurate documentation.

FIELD-BASED REMOTE | Behavioral Health Case Worker - Serious Mental Illness (Orangeburg County, SC)

Behavioral Health Case Worker

The Behavioral Health Case Manager, RN at Health Plans, Inc. is responsible for the coordination of services and cost-effective management of health care resources to meet individual members' health care needs and promote positive health outcomes. This role involves communication with members, physicians, and other health care professionals, telephonic assessment for discharge outreach, determination of case management outcomes, advocacy for health benefit plan options, and ensuring excellent communication among the member, family, and health care team.

Behavioral Health Case Manager, RN (Remote)

Behavioral Health Case Manager, RN

The Senior Medical Director, Behavioral Health & Medical Director, Operations at Blue Shield of California will be responsible for psychiatric inpatient concurrent review, pre- and post-service utilization review, and collaboration with Nurse Care Managers. This role involves medical decision-making, training staff, performing clinical reviews, and participating in quality management and projects. The ideal candidate will have a strong background in behavioral health clinical practice, particularly in hospital settings, and experience in Health Plan utilization management, case review, and quality improvement activities.

Senior Medical Director, Behavioral Health & Medical Director, Operations (Behavioral Health)

Senior Medical Director, Behavioral Health & Medical Director, Operations

The Behavioral Health Network Relations Manager at CVS Health is a full-time, remote role focused on managing relationships with larger and more complex behavioral health providers. This individual will act as the primary resource for assigned providers, overseeing risk management, maintaining positive relationships, and supporting high-value initiatives to achieve provider satisfaction, cost targets, network growth, and efficiency targets. The role involves cross-functional collaboration, issue resolution, and ensuring compliance with contract policies and procedures.

Behavioral Health Network Relations Manager

The Behavioral Healthcare Manager at AmeriHealth Caritas is responsible for the daily functions of the clinical department, including triage of calls, care coordination, and utilization management. This role facilitates access to behavioral health, substance use, and intellectual/developmental disabilities therapeutic services, ensuring that every youth receives the right services at the right time as part of an integrated service plan. The manager makes timely intensity of services determinations based on the urgency of need, including the management of emergencies, which includes access to mobile response services.

Behavioral Healthcare Manager - Tuesday through Friday, 10:00 p.m. EST to 8:00 a.m. EST

Behavioral Healthcare Manager

Maxim Healthcare Services in Los Angeles is seeking an intensive behavioral support (IBS) caregiver to work with children and/or adults with developmental delays and challenging behaviors. This role involves providing one-to-one behavior intervention services, assisting with daily activities, and implementing behavior support plans. The position offers competitive pay, benefits, college partnership programs, flexible scheduling, and ongoing supervision from a Board Certified Behavior Analyst (BCBA).

Behavioral Support Provider $21 - $25 / hr

Behavioral Support Provider

This job involves implementing effective utilization management strategies, including reviewing the appropriateness of health care services, applying criteria to assure appropriate resource utilization, identifying opportunities for referral to a Health Coach/case management, and resolving quality issues. The role monitors and analyzes the delivery of health care services, educates providers and members, and develops strategies to improve provider performance/satisfaction and member satisfaction. Responses to customer inquiries and interventions or alternatives are offered.

Care Manager Behavioral Health (Remote)

Care Manager Behavioral Health

The Care Manager, Behavioral Health at Magellan Health Services is a remote position supporting Louisiana, requiring a license in Louisiana. This role involves authorizing and reviewing utilization of mental health and substance abuse services, collecting and analyzing utilization data, assisting with discharge planning and care coordination, and participating in quality improvement projects. The position requires strong organization, time management, and communication skills, as well as knowledge of utilization management procedures, mental health and substance abuse community resources, and providers.

Care Manager, BH - Remote (Louisiana license required)

Care Manager, Behavioral Health

Molina's Behavioral Health Medical Director provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services. This role involves standardizing utilization management policies and procedures, improving quality outcomes, decreasing costs, and ensuring compliance with industry standards and best practices.

Medical Director, Behavioral Health

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