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 Behavioral Health Care Manager at Healthfirst is responsible for advocating, informing, and educating beneficiaries on services, self-management techniques, and health benefits. This role involves conducting assessments to identify barriers and opportunities for intervention, generating referrals to providers and community-based resources, and coordinating care between service providers to ensure successful health outcomes. The position requires strong interpersonal and assessment skills, especially in working with seniors and their families.

Remote Behavioral Health Care Manager (HIE)

Behavioral Health Care Manager

The Part-Time Behavioral Health Medical Director at Acentra Health is responsible for providing clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. This role involves leading Behavioral Health physician reviewers, making clinical determinations on behavioral health service requests, and ensuring compliance with regulatory and accreditation requirements.

Behavioral Health Medical Director

The Supervisor, Behavioral Health Utilization Management Review at AmeriHealth Caritas is responsible for overseeing up to 18 UM Clinical Care Reviewers and staff members across 3 Medicaid and 11 Medicare Plans. This role involves providing clinical, technical, and operational support, including the organization and monitoring of all medical services. The position requires direct supervisory oversight of professional and front-line staff handling authorization requests from both internal and external customers.

Supervisor, Behavioral Health Utilization Management Review, BSN/LPC/ LCSW/LISW/LCMHC

Supervisor, Behavioral Health Utilization Management Review

The Behavioral Health Therapist at Sanford Health requires a broad and thorough understanding of human behavior, theories of counseling, and psychopathology. This role involves working with a wide range of patient populations and presenting issues, requiring a foundation in a variety of treatment modalities. The therapist has total independence and responsibility for patient well-being, providing diagnostic assessment, onsite crisis assessment and intervention, and determining the need for ongoing care. They develop treatment plans, implement interventions specific to patient needs, and document treatment sessions.

Remote Behavioral Health Therapist | Virtual Care

Behavioral Health Therapist

The Utilization Management Clinician Behavioral Health at CVS Health is a fully remote position responsible for utilizing clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program for Behavioral Health. This role involves applying critical thinking, clinical appropriate treatment, evidence-based care, and clinical practice guidelines to facilitate appropriate healthcare services/benefits for members. The position requires a Master's degree in a relevant field and offers a comprehensive benefits package.

Utilization Management Clinician Behavioral Health

The Behavioral Health Medical Director at CVS Health is responsible for developing, implementing, supporting, and promoting Health Services strategies, tactics, policies, and programs to drive the delivery of quality healthcare. This role involves leading utilization management, quality management, network management, and clinical coverage and policies to ensure high-value healthcare and competitive business advantage. The position is work-from-home with occasional travel, focusing on overseeing behavioral health activities in health plans, including coordination with federal and state agencies, provider education, and quality improvement.

The Behavioral Health Care Advocate is responsible for guiding telephonic reviews, obtaining clinical information from behavioral health providers, reviewing treatment plans, determining appropriate levels of care, and administering public behavioral health benefits. This role involves overseeing authorization requests, coordinating transitions between levels of care, and providing telephonic assessment and triage for participants in behavioral health crisis. The position requires living in the state of Maryland.

Remote Behavioral Care Advocate

Behavioral Health Care Advocate

As a Behavioral Health Specialist at Banner Thunderbird Medical Center, you will provide direct care to psychiatric patients under the direction of a registered nurse. This role involves a variety of tasks including safety checks, assisting in ADLs, milieu management, falls prevention measures, and one-on-one observations. The position is based in a Level I Trauma for adults and Tertiary Care destination for all ages, offering a wide range of mental health diagnoses requiring acute medical care. Full-time day shifts are available, including weekends and holidays on a rotating basis.

Behavioral Health Specialist

The Manager Behavioral Health Clinical Services is responsible for managing the clinical operations department, including quality care management, clinical utilization, and referral services. This role involves managing psychiatric/substance abuse cases, identifying areas for quality improvement, interfacing with internal and external customers, and ensuring compliance with all performance standards and regulatory requirements. The position requires a BA/BS in a mental health field or an AA in Nursing with related psychiatric nursing experience, along with a minimum of 5 years of behavioral healthcare experience and 3 years of managed care experience.

Manager Behavioral Health Clinical Services

This remote position is responsible for the assessment, reassessment, care planning, and coordination of care and services for members with behavioral health conditions requiring intensive interventions and oversight. The role involves developing individualized care plans, conducting health risk assessments, providing telephone triage, crisis intervention, and prior authorizations, and overseeing the work of the assigned care support team. The position requires licensure and residing in California.

BH Care Manager, Health Plan, Licensed in CA, Remote

The Senior Medical Director at UPMC Community Care will lead the behavioral health care delivered to Community Care members, ensuring the quality and efficiency of care. This role involves significant responsibility for quality management, utilization management, and the adequacy of the provider network. The position offers the opportunity to lead a mission-driven organization focused on improving community health through behavioral health services, with the flexibility to be based anywhere within Pennsylvania.

Psychiatrist Senior Medical Director - Behavioral Health

Senior Medical Director - Behavioral Health

The Medical Director, Behavioral Health at Magellan Health Services supports the clinical vision for the health plan(s) across all lines of business (Medicaid, Medicare, and Commercial) and implements programs to support this vision. This role involves clinical leadership, including oversight of clinical team members, consultation and training with care managers, and day-to-day physician oversight of an interdisciplinary UM team. The position also includes developing and implementing a Utilization Management program, ensuring high-quality patient care, and participating in the appeals process and continuous quality improvement activities.

Medical Director, BH - TX licensed, Remote (part time)

Medical Director, Behavioral Health

The Behavioral Health Medical Director at AmeriHealth Caritas provides clinical oversight and direction to the Clinical Department, including oversight of the Quality Improvement program. This role involves participating in QI Committee meetings, providing clinical consultation, making medical necessity and appropriateness decisions, reviewing and approving the Outcomes Management and Quality Improvement Plan, and supporting the clinical department in applying Medical Necessity Criteria. The position is remote but requires candidates to reside in Ohio.

Behavioral Health Medical Director (must reside in OH)

The Behavioral Services Psychotherapist provides evidence-based care in the diagnosis and treatment of mental illness and substance use disorders within an interdisciplinary team. This role involves individual, conjoint, group, and family psychotherapy, as well as crisis intervention services. The psychotherapist ensures that the quality of care is safe, effective, patient-centered, timely, efficient, and equitable.

Psychotherapist Behavioral Services Part Time Days Remote

Behavioral Services Psychotherapist

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Supervisory Behavioral Health Provider Jobs in Surprise, AZ Hiring Now

Care Manager Behavioral Health (Remote)

Remote Behavioral Health Care Manager (HIE)

Behavioral Health Medical Director

Supervisor, Behavioral Health Utilization Management Review, BSN/LPC/ LCSW/LISW/LCMHC

Remote Behavioral Health Therapist | Virtual Care

Utilization Management Clinician Behavioral Health

Behavioral Health Medical Director

Remote Behavioral Care Advocate

Behavioral Health Specialist

Manager Behavioral Health Clinical Services

BH Care Manager, Health Plan, Licensed in CA, Remote

Psychiatrist Senior Medical Director - Behavioral Health

Medical Director, BH - TX licensed, Remote (part time)

Behavioral Health Medical Director (must reside in OH)

Psychotherapist Behavioral Services Part Time Days Remote