Behavioral Health Utilization Manager-outpatient

We are seeking an experienced Behavioral Health Utilization Manager to support inpatient and residential behavioral health services through concurrent reviews, discharge planning, and transition of care coordination. Qualifications: Must have 57 years UM experience in inpatient/residential settingsActive independent license required (LICSW / LMHC / LMFT)Strong skills in LOC determinations, care coordination, and documentationFully remote with occasional travel for meetings/training.

The Technical Product Manager for InterQual AutoReview will lead execution of AI-enabled utilization management capabilities, translating clinical, operational, and integration requirements into clear, testable product deliverables. This role partners closely with engineering, data science, clinical SMEs, and EHR integration teams to deliver scalable, production-ready automation within regulated healthcare workflows. Key Responsibilities Define and manage backlog for AutoReview features tied to

This position is 100 % remote !! Our client, a major Federal Healthcare Insurance organization based in Washington DC, is seeking a Business/Organizational Change Manager to help support a Organizational level, Joint Collaboration (B2B) culture change and technology adaptation effort, at the enterprise level. We are seeking a seasoned BCM, who is professional, organized, enthusiastic and a team player who can work independently and collaboratively on complex, highly visible, cross-functional str

JOB DESCRIPTION Job Summary Provides advanced clinical and operational expertise to ensure delegated clinical functions - such as Utilization Management (UM), Care Management (CM), Behavior Health (BH), Disease Management (DM), and Quality programs - meet expected financial and clinical outcomes, organizational contractual, regulatory, and accreditation (NCQA, CMS, State) requirements. Leads end-to-end oversight activities, including performance monitoring, audits, corrective action management,