Top 34 Behavioral health utilization review Jobs in Wisconsin

Care Review Clinician (RN)(Behavioral Health)
Molina Healthcare —Wisconsin
- $26.41 - $51.49 an hour
- Full-time
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
BH Case Manager: Weekend Program
Advocate Aurora Health —Wauwatosa, WI
- $33.05 - $49.60 an hour
- Part-time
- Nursing
- RN License
- BLS Certification
Intake RN/FT/NOC
Miramont Behavioral Health —Middleton, WI
- Full-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
PRN Intake Clinician RN or Licensed Therapist
Willow Creek Behavioral Health —Green Bay, WI
- Part-time
- CPR Certification
- Nursing
- RN License
Quick Apply
Program Supervisor
NRG MGMT LLC —Germantown, WI
- $50,000 - $85,000 a year
- Addiction Medicine
- Mid-level
- Master's degree
- Health insurance
- Dental insurance
2d
RN Care Manager
Network Health, Inc —Menasha, WI
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
Case Manager (CM)
Rehabilitation Hospital of Oak Creek —Oak Creek, WI
- Part-time
- RN License
- Hospital
- Physical & Rehabilitation Medicine
- Disability insurance
- Health insurance
Quick Apply
Collaborative Care Behavioral Health Provider (Therapist) - Boscobel
Gundersen Health System —Boscobel, WI
- Full-time
- LMFT
- Licensed Clinical Social Worker
- LPC
Outpatient Psychotherapist
Advocate Aurora Health —Oshkosh, WI
- $35.50 - $53.25 an hour
- Full-time
- LMFT
- Addiction Medicine
- LPC
3d
Mental Health Counselor
Genesis / Matt Talbot / Horizon —Racine, WI
- Full-time
- Mid-level
Quick Apply
Substance Use Disorder Counselor (SACIT)
Genesis / Matt Talbot / Horizon —Milwaukee, WI
- Full-time
- Mid-level
Quick Apply
Behavior Specialist: Pool 2 - Ocon Inpatient
Rogers Memorial Hospital, Inc. —Oconomowoc, WI
- Part-time
- Acute care
- Medication administration
- Hospital
- Wellness program
- Disability insurance
Quick Apply
2d
Senior Social Worker - Emergency Department Mental Health Clinician
US Veterans Health Administration —Milwaukee, WI
- $94,539 - $122,903 a year
- Weekends as needed
- Acute care
- Background check
- Master of Social Work
- Paid parental leave
- Paid holidays
3d
Outpatient Therapist
Advocate Aurora Health —Wauwatosa, WI
- $35.50 - $53.25 an hour
- Full-time
- LMFT
- Addiction Medicine
- Licensed Clinical Social Worker
2d
Residential Supervisor
Rogers Memorial Hospital, Inc. —Oconomowoc, WI
- Full-time
- Mid-level
- Residential
- Master's degree
- Wellness program
- Health savings account
Quick Apply
Staff Psychologist - Emergency Department Mental Health Clinician
US Veterans Health Administration —Milwaukee, WI
- $82,327 - $152,542 a year
- Weekends as needed
- Acute care
- Background check
- Doctoral degree
- Paid parental leave
- Paid holidays
3d
Psychotherapist Outpatient
Advocate Aurora Health —Sheboygan, WI
- $35.50 - $53.25 an hour
- Full-time
- LMFT
- Addiction Medicine
- Licensed Clinical Social Worker
1d
Substance Abuse Counselor
Genesis / Matt Talbot / Horizon —Oshkosh, WI
- Full-time
- Addiction Medicine
- Mid-level
Quick Apply
Substance Use Disorder Counselor (GBS)
Genesis / Matt Talbot / Horizon —Delavan, WI
- Full-time
- Mid-level
- Rehabilitation center
Quick Apply
Care Coordinator - Comprehensive Community Services
Wellpoint Care Network —Milwaukee, WI
- Online Application
- Hybrid work
- Master of Social Work
- Clean driving record
- Microsoft Excel
- Loan forgiveness
Quick Apply

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behavioral health utilization review jobs near wisconsin

Care Review Clinician (RN)(Behavioral Health)

Molina Healthcare -
Wisconsin

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Acute care facility experience
Working with individuals with mental health conditions
Productivity software

Full Job Description

JOB DESCRIPTION

Behavioral Health experience required.

Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

behavioral health utilization review jobs in wisconsin

Care Review Clinician (RN)(Behavioral Health)

BH Case Manager: Weekend Program

Intake RN/FT/NOC

PRN Intake Clinician RN or Licensed Therapist

Program Supervisor

RN Care Manager

Case Manager (CM)

Collaborative Care Behavioral Health Provider (Therapist) - Boscobel

Outpatient Psychotherapist

Mental Health Counselor

Substance Use Disorder Counselor (SACIT)

Behavior Specialist: Pool 2 - Ocon Inpatient

Senior Social Worker - Emergency Department Mental Health Clinician

Outpatient Therapist

Residential Supervisor

Staff Psychologist - Emergency Department Mental Health Clinician

Psychotherapist Outpatient

Substance Abuse Counselor

Substance Use Disorder Counselor (GBS)

Care Coordinator - Comprehensive Community Services

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