Remote Behavioral Health Utilization Review Clinician
Centene Corporation
- Remote job
Centene Corp. offers a fully remote Utilization Review Clinician - Behavioral Health role. The position emphasizes clinical review of mental health and substance use services, with a standard CST schedule and holiday rotation. US-based candidate with graduate nursing or a Bachelor’s degree plus 2–4 years' related experience is preferred; master’s in behavioral health is strongly recommended. Licensure in BH or RN state licensure may be required. #J-18808-Ljbffr Centene Corp.
- ...Centene Corporation is seeking a remote BH utilization reviewer to assess mental health and substance abuse care, authorize services, and present findings to... ...4 years of experience and an applicable license. A master’s in behavioral health is preferred. #J-18808-Ljbffr...Remote work
$27.02 - $48.55 per hour
...Medical Management/Health Services team.... ...Performs a clinical review and assesses care... ...review of behavioral health (BH) inpatient... ...and appropriate utilization of services Provides... ...health clinicians required. Clinical... ...approach to work with remote, hybrid, field or...Remote workHourly payFull timeContract workPart timeWork at officeFlexible hours- Centene is seeking an Inpatient Utilization Review Clinician for Behavioral Health to perform clinical reviews and assessments ensuring appropriate care for... ...coordination of care across providers. The position offers remote flexibility with a 8am-5pm schedule on days (Tuesday-...Remote jobWeekend work
- ...Manpower Group (USA) is seeking a clinically driven RN or LPN with utilization management experience for a fully remote, temporary role. You will evaluate behavioral health and medical necessity reviews to authorize appropriate levels of care, impacting member outcomes....Remote workTemporary work
- Centene Corp. seeks an Utilization Review Clinician in a remote role requiring Georgia licensure. You will review mental health and substance use services, handling prior authorizations and concurrent inpatient reviews while collaborating with providers and medical directors...Remote job
- ...diversified national organization is seeking a Licensed Clinical Behavioral Health Professional or RN to assess care related to mental health... ...evaluating treatment needs, performing authorization reviews, and improving service quality. Ideal candidates should have...Remote jobFlexible hours
$40 - $45 per hour
...re a clinically driven RN or LPN with utilization management experience and a passion... ...meaningful coverage decisions, this remote opportunity offers the chance to directly... ...your expertise in medical necessity review and behavioral health services helps ensure members receive...Remote workHourly payTemporary workMonday to Friday- Point32Health in Massachusetts seeks a Behavioral Health Utilization Management Clinician to conduct benefit coverage reviews and clinical determinations under supervision within... ...while maintaining regulatory compliance. Remote work as required with a fast-paced environment...Remote job
$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity... ...pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the... ...) Bachelor’s degree in a health or behavioral health-related field required...Remote work- Comagine Health is seeking a Clinical Reviewer to work remotely from Oregon with travel across the Eugene and surrounding areas. You will... ..., 3 years of direct patient care in behavioral health, and familiarity with utilization review. #J-18808-Ljbffr Comagine HealthRemote job
$2,000 per week
...RadHealth+ is seeking a travel nurse RN Remote Case Manager, Utilization Review for a travel nursing job in... ...Nursing Assistants & LPNs Allied Health Professionals (PT, OT, RT, Lab Techs... ...Rapid Response Teams Allied & Behavioral Health Speech & Language Pathologists...Remote workWeekly payFor contractorsLocal areaShift workNight shift- Gainwell Technologies is seeking a Behavioral Health Prior Authorization reviewer to adjudicate submissions for Substance Use Disorder Treatment... ...Adult Mental Health Day Treatment. This 100% remote role involves utilization review and quality assurance with no direct...Remote job
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- Comagine Health is seeking a Clinical Reviewer with LCSW/LPC/LCPC licensure for a remote, Oregon-based role requiring travel to Salem and surrounding areas. Review clinical... ...populations. The position emphasizes utilization review, documentation, and collaboration with...Remote jobWork from home
- ...One of the largest health benefits companies in the... ...benefits, dental, vision, behavioral health benefit... ...authorization and concurrent review. Provides monthly... ...treatment setting by utilizing the applicable medical... ...Additional Info: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
- Blue Shield of CA is seeking a Behavioral Health Utilization Management Clinician, Senior, to conduct clinical reviews of mental health and substance use authorization requests across levels of care. This role supports medical necessity, coding accuracy, and policy compliance...Work at office
- ...Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental health and substance use services. This remote role may require on-site travel to Roseburg, OR as needed and offers a full-time exempt schedule. The URC collaborates with care...Remote workFull time
- ...Utilization Review NurseThis position has a remote option for those living close and will be able to come into the hospital... ...with other members of the health care team to ensure the above according... ...'s member's health care for behavioral health care management.Follow CHRISTUS...Remote workFull time
- ...Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days... ...help patients achieve optimal health, access to care, and appropriate... ...years of acute hospital or behavioral health patient care... ...Locations Thop Transmountain Campus (Remote) #J-18808-Ljbffr...Remote workFull timeWork at officeFlexible hoursShift work
- ...Comagine Health is seeking a Behavioral Health Reviewer based in Oregon. Responsibilities include reviewing clinical documentation for medical necessity, conducting assessments, and managing referrals in a remote capacity. Applicants should possess a relevant master's...Remote work
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
$27.02 - $48.55 per hour
...Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA)... ...Key Details: This is a remote position; however,... ...quality and appropriate utilization of services Interacts... ...behavioral health clinicians required. Behavioral...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours$130 - $145 per hour
...Job Description Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance... .... Work Location: This position is fully remote and open to candidates residing in the U.S.,...Remote workHourly payFull timePart timeWork from homeHome office- ...This is a great opportunity for a local remote position. Schedule PRN (As... ...support all units/staff (commercial, behavioral health, inpatient, etc). Requirements:... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing hospital admissions...Remote workReliefLocal areaMonday to FridayFlexible hoursShift work
- ...A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
- ...Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) for a fully remote role. You will review home health documentation, audit OASIS and care plans, and ensure coding accuracy to protect reimbursement integrity. Qualified candidates hold an...Remote work
- ...WellSense Health Plan is seeking an Inpatient Utilization Management Clinician for a fully remote role in the United States. You will evaluate inpatient medical necessity, monitor... ...nursing degree, and 2 years of utilization review experience with InterQual. #J-18808-Ljbffr...Remote work
- ...Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization requests. The role requires documentation... ...necessity criteria, and coordinating with Medical Directors. Remote options are available for eligible candidates. The position...Remote work
- ...management and specialty pharmacy services, behavioral health services, and other administrative... ...of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical... ...Package Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workFull timeWork at officeMonday to FridayFlexible hours
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