... review and other utilization management activities aimed at providing Molina Healthcare members ... members including Behavioral Health and Long Term Care. Qualifications Minimum Education ...
... review and other utilization management activities aimed at providing Molina Healthcare members ... members including Behavioral Health and Long Term Care. Qualifications Minimum Education ...
RN Utilization Review Nurse
$33 - $37/hr
Providing utilization review for the Medicaid and Medicare line of business ... Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * ...
RN Utilization Review Nurse
$33 - $37/hr
Providing utilization review for the Medicaid and Medicare line of business ... Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * ...
... including Behavioral Health and Long Term Care. Qualifications Must be an RN Utilization Review ... background in either Managed Care of Provider environment (at least one year) Interqual experience ...
... including Behavioral Health and Long Term Care. Qualifications Must be an RN Utilization Review ... background in either Managed Care of Provider environment (at least one year) Interqual experience ...
Utilization Review Manager
Grand Rapids, MI · On-site
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Manager
Grand Rapids, MI · On-site
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Analyst HYBRID (PCN 1542)
Troy, MI · On-site
$56K - $70K/yr
Conduct concurrent utilization reviews of behavioral health services for acute psychiatric hospitals, state psychiatric facilities, and other levels of care to determine medical necessity ...
Quick apply
Utilization Review Analyst HYBRID (PCN 1542)
Troy, MI · On-site
$56K - $70K/yr
Conduct concurrent utilization reviews of behavioral health services for acute psychiatric hospitals, state psychiatric facilities, and other levels of care to determine medical necessity ...
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Manager
Grand Rapids, MI · On-site
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Manager
Grand Rapids, MI · On-site
... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
Job Summary The Supervisor of Utilization Review (UR) oversees the development, implementation, and ... or behavioral health setting. * Experience with NCQA, MDHHS, HSAG, and/or accreditation and ...
Quick apply
Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
Job Summary The Supervisor of Utilization Review (UR) oversees the development, implementation, and ... or behavioral health setting. * Experience with NCQA, MDHHS, HSAG, and/or accreditation and ...
Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
This role is responsible for reviewing behavioral health services to ensure medical necessity ... Conduct utilization reviews for behavioral health services, including initial, concurrent, and ...
Quick apply
Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
This role is responsible for reviewing behavioral health services to ensure medical necessity ... Conduct utilization reviews for behavioral health services, including initial, concurrent, and ...
... Behavioral Health and Long Term Care. Qualifications Minimum Education/Qualifications/Licensures: Utilization Review background in either Managed Care of Provider environment (at least one year ...
... Behavioral Health and Long Term Care. Qualifications Minimum Education/Qualifications/Licensures: Utilization Review background in either Managed Care of Provider environment (at least one year ...
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... behavior. 25. Safeguard Protected Health Information (PHI) by strictly adhering to the "minimum ...
New
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... behavior. 25. Safeguard Protected Health Information (PHI) by strictly adhering to the "minimum ...
New
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... behavior. 25. Safeguard Protected Health Information (PHI) by strictly adhering to the "minimum ...
New
Day Shift Description: The Utilization Review (UR) Coordinator collaborates with a ... behavior. 25. Safeguard Protected Health Information (PHI) by strictly adhering to the "minimum ...
New
... utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare Qualifications Hours for this Position:
... utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare Qualifications Hours for this Position:
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well as State and Federal Mandates. May perform clinical ...
... for behavioral health services utilization across the region respective to the Region 10 PIHP ... Review (UR) activities across the CMH and SUD provider networks, including case finding and case ...
... for behavioral health services utilization across the region respective to the Region 10 PIHP ... Review (UR) activities across the CMH and SUD provider networks, including case finding and case ...
... Behavioral Health and Long Term Care Providing utilization review for the Medicaid and Medicare ... line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and ...
... Behavioral Health and Long Term Care Providing utilization review for the Medicaid and Medicare ... line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and ...
UR COORDINATOR
Augusta, MI · On-site
... behavioral health facilities and 30 outpatient and other facilities located in 37 states ... Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance ...
UR COORDINATOR
Augusta, MI · On-site
... behavioral health facilities and 30 outpatient and other facilities located in 37 states ... Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance ...
... behavioral health facilities and 30 outpatient and other facilities located in 37 states ... Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance ...
... behavioral health facilities and 30 outpatient and other facilities located in 37 states ... Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance ...
Behavioral Utilization Review information
What is the difference between Behavioral Utilization Review vs Behavioral Case Manager?
| Aspect | Behavioral Utilization Review | Behavioral Case Manager |
|---|---|---|
| Credentials | Licensed mental health professionals, certifications vary | Licensed clinical social workers, counselors, or therapists |
| Work Environment | Review settings, insurance companies, healthcare facilities | Direct patient interaction, hospitals, outpatient clinics |
| Employer & Industry | Insurance companies, healthcare organizations | Hospitals, mental health agencies, managed care |
| Primary Focus | Assessing medical necessity, reviewing treatment plans | Coordinating care, supporting treatment adherence |
Behavioral Utilization Review primarily involves evaluating the necessity of mental health services through review processes, while Behavioral Case Managers focus on coordinating patient care and supporting treatment plans. Both roles require mental health credentials but differ in daily tasks and work settings.
What are popular job titles related to Behavioral Utilization Review jobs in Michigan?
For Behavioral Utilization Review jobs in Michigan, the most frequently searched job titles are:
- Night Shift Remote Utilization Review Nurse
- Utilization Review Specialist
- Per Diem Utilization Review Nurse
- Medical Review Coordinator
- Full Time Physician Advisor Utilization Review
- Utilization Review Nurse
- Utilization Review Therapist
- Utilization Review Physician
- Utilization Management
- Weekend Physician Advisor Utilization Review
What job categories do people searching Behavioral Utilization Review jobs in Michigan look for?
The top searched job categories for Behavioral Utilization Review jobs in Michigan are:
- Temporary Aetna Utilization Review Nurse
- Remote Optum Utilization Review
- Utilization Review Manager
- Manager Optum Utilization Review
- Utilization Review Assistant
- Utilization Review Coordinator
- Director Optum Utilization Review
- Utilization Review Clinician
- Director Of Utilization Review
- Manager Aetna Utilization Review
What cities in Michigan are hiring for Behavioral Utilization Review jobs?
Cities in Michigan with the most Behavioral Utilization Review job openings:
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Company: Molina Healthcare
Location: 880 Long Lake Rd Suite 600Â Troy, Michigan 48098
Shift: Daytime hours
Employment: Contract: 1-2 months (possibility of going longer depending on business needs)
Company Job Description/Day to Day Duties:
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines
Provider appeals and Utilization reviews and assist with Denial LettersÂ
Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.Â
Qualifications
Minimum Education/Qualifications/Licensures:
Must be an RNÂ
Utilization Review background in either Managed Care of Provider environment (at least one year)Â
Interqual experienceÂ
Other basic computer skills necessary: Microsoft Office, Data Entry, etc.Â
Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
Also has a background in patient, skilled nurses facilities, rehab, and home healthcare. Â
Additional Information
Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact.
Thanks and look forward to hearing from you!
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003