Utilization Review Nurse
Troy, MI · On-site
... review and other utilization management activities aimed at providing Molina Healthcare members ... members including Behavioral Health and Long Term Care. Qualifications Minimum Education ...
Utilization Review Nurse
Troy, MI · On-site
... review and other utilization management activities aimed at providing Molina Healthcare members ... members including Behavioral Health and Long Term Care. Qualifications Minimum Education ...
Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan , dedicated to ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan , dedicated to ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
Overview Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
Overview Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
Overview Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
Overview Join StoneCrest Center, a 182-bed behavioral health hospital in Detroit, Michigan ... As the Director of Utilization Review , you will play a critical leadership role in ensuring the ...
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. * ...
Utilization Review- RN
Troy, MI · On-site
... 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- RN
Troy, MI · On-site
... 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 ...
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
New
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
New
... 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. 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 ...
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 ... Performs a variety of concurrent and retrospective utilization management-related reviews and ...
Conduct concurrent utilization reviews of behavioral health services for acute psychiatric hospitals, state psychiatric facilities, and other levels of care to determine medical necessity ...
Conduct concurrent utilization reviews of behavioral health services for acute psychiatric hospitals, state psychiatric facilities, and other levels of care to determine medical necessity ...
$90 - $115/hr
... behavioral health problems. As a part of our continued success and growth, we are seeking qualified applicants for a Utilization Review Manager. Position Description The Utilization Manager is ...
$90 - $115/hr
... behavioral health problems. As a part of our continued success and growth, we are seeking qualified applicants for a Utilization Review Manager. Position Description The Utilization Manager is ...
... 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 ...
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 ...
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 ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Manager of Utilization Review
Saint Johns, MI · On-site
$90 - $120/hr
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Manager of Utilization Review
Saint Johns, MI · On-site
$90 - $120/hr
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...
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.
How to become a behavioral utilization review?
To become a behavioral utilization review specialist, candidates typically need a bachelor's degree in psychology, social work, nursing, or a related field. Relevant experience in mental health or healthcare settings, along with knowledge of insurance policies and utilization review processes, is important; some roles may require certification such as the Certified Professional in Utilization Review (CPUR).
Is behavioral utilization review a stressful job?
Behavioral utilization review can be stressful due to the need to evaluate complex mental health cases, meet strict deadlines, and handle sensitive patient information. The role often requires strong attention to detail, critical thinking, and emotional resilience, which can contribute to job-related stress.
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:
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:
- Commission Authorization Utilization Review Bcba
- Remote Utilization Review
- Remote Hca Utilization Review
- Manager Aetna Utilization Review
- Temporary Medical Utilization Review Physician
- Ur
- Lpn Utilization Review Work From Home
- Utilization Review Coordinator Remote
- Aetna Utilization Review Nurse
- Utilization Review Nurse Compact License
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 600 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 Letters
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.
Qualifications
Minimum Education/Qualifications/Licensures:
Must be an RN
Utilization Review background in either Managed Care of Provider environment (at least one year)
Interqual experience
Other basic computer skills necessary: Microsoft Office, Data Entry, etc.
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.
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