Utilization Management Review (RN, LCSW, LMSW, LMHC) - Multiple Positions!
Excellus BCBS(1 month ago)
About this role
This role coordinates, integrates, and monitors utilization of behavioral or physical health services for health plan members, ensuring compliance with regulatory and accreditation standards. The position supports referral of cases to the Medical Director and works closely with Case Management and provider partners. The role may include on-call rotation, regional travel, and occasional additional hours based on departmental needs.
Required Skills
- Clinical Review
- Utilization Management
- Case Coordination
- Medical Policy
- Provider Relations
- Care Management
- Coding
- Microsoft Office
- Communication
- Multi-tasking
Qualifications
- Associates Degree
- Bachelors Degree Preferred
- Active NYS RN License
- Active NYS LMSW
- LCSW
- LMHC
About Excellus BCBS
excellusbcbs.comOfficial site of Excellus BCBS, a trusted health insurance plan for over 85 years. Shop for affordable health plans including Medicare, medical, dental, vision, and employer plans.
View more jobs at Excellus BCBS →Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at Excellus BCBS
Quality Measurement Analytics Consultant I/II/III
Excellus BCBS(20 hours ago)
Provider Reimbursement & Network Services Analyst I/II/III
Excellus BCBS(5 days ago)
Provider Program Quality & Integration Consultant I/II
Excellus BCBS(6 days ago)
Utilization Management Services Rep I
Excellus BCBS(6 days ago)
Similar Jobs
Utilization Management Clinician
PacificSource Health Plans(22 days ago)
Nurse Manager - Utilization Review
Huron Consulting(2 months ago)
Utilization Review Nurse
Brigham and Women(1 month ago)
Utilization Review Nurse
Oscar Health(2 months ago)
Manager Utilization Review
St. Luke's Hospital(25 days ago)
Utilization Review Specialist - OP
Summit BHC(1 month ago)