Remote Behavioral Health Utilization Reviewer
Baystate Health
Health New England is seeking a Behavioral Health Utilization Management Reviewer in Springfield, MA. The role focuses on medical necessity reviews and care coordination to support positive clinical outcomes for members. You will collaborate with physicians, care managers, and community resources, ensuring timely documentation and adherence to regulatory standards. A MA license in LICSW/LCSW/LMHC/psychologist or RN with BH experience is required. #J-18808-Ljbffr
- ## HNE Behavioral Health Utilization Management ReviewerApplylocations: Springfield, Massachusettstime type... ...Health Utilization Management Reviewer**, you'll play a vital role in ensuring... .../onboarding – this position is fully remote. **Candidate must hold professional license...Remote workHourly payFull time
- ...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
- ...team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern... .... Ready to join our quest for better? *Shifts are weekdays. Utilization Reviewer Responsibilities Responsible for utilization review calls within...SuggestedFor contractorsReliefWork at officeLocal areaRelocation packageShift workWeekday work
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote workFor contractorsMonday to FridayFlexible hours
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The... ...Medicine, preferably with experience in health insurance. This position offers a... ...opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...Overview Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with flexible...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services.... ...license to practice in the US. This position offers remote work options and competitive compensation...Remote workFull time
- ...organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical... .... A comprehensive benefits package including health plans and 401(k) is offered, promoting equality...Remote work
- ...Dane Street, a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...Remote work
$174.07k - $374.92k
...We're building a world of health around every individual - shaping a more connected, convenient and compassionate... ...Company: Oak Street Health Title: Full-Time Utilization Management Physician Reviewer Location: Remote/ Treehouse Role Description: This...Remote workHourly payFull timeLocal area- At Cleveland Clinic Health System, we believe in a better future for healthcare... ...of Every One. Job Title PRN Utilization Management RN Reviewer NE Location Weston... ...with weekend requirements. This remote role is limited to Florida, Ohio, and...Remote workFull timeReliefWork at officeShift workWeekend work
$219k - $286.9k
...Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack... ...Management. Work Location: This is a remote position, open to candidates who reside in the...Remote workFull timeLocal areaWork from homeHome officeWeekend work$65k - $88.6k
...Join Our Caring Community The Utilization Management Behavioral Health Professional uses behavioral health... ...basic technical difficulties in a remote environment. Ability to work independently... ...of experience with utilization review process ~ Experience with...Remote workTemporary workPrivate practiceWork at officeWork from homeHome office- ...WellSense Health Plan is seeking a Behavioral Health Utilization Manager to ensure effective delivery of mental health services. This role emphasizes clinical... ...significant experience in behavioral health management. Remote work is available, but candidates might need to...Remote work
- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Remote workFull time
- ...Centene Corp. is seeking an Utilization Review Clinician in Behavioral Health to perform clinical reviews and determine the medical necessity of BH services. The role supports Oklahoma Complete Health – Behavioral Health Utilization Management, with a schedule that includes...Remote workEarly shift
$42.18 - $51.56 per hour
## PT Utilization Management ReviewerApplylocations: Hinghamtime type: Full timeposted on... ...Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness... ...team includes clinicians, medical and behavioral health care managers, dietitians, pharmacists...Work at officeFlexible hoursShift work- Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote job
- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...independently applies medical and behavioral health guidelines to authorize services,... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workMonday to FridayFlexible hoursWeekend work
- ...Utilization Management Behavioral Health Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans...Remote workWork experience placementRotating shift
$60.2k - $107.4k
Istss in Eden Prairie, MN is seeking a Behavioral Health Advocate for a telephonic role supporting outpatient services for children and adolescents... ...experience and qualifications. The role includes performing utilization management, ensuring appropriate services, and referring...Remote job- ...leading healthcare solutions provider is seeking a Nurse Reviewer (Registered Nurse) for a remote role in the US. The ideal candidate will have over 5... ...benefits starting on the first day of employment, including health coverage and a supportive work environment focused on...Remote workFull time
- WellSense Health Plan in Boston is seeking a Behavioral Health Utilization Manager to ensure the effective delivery of mental health and substance use disorder services... ...in a relevant field. This position is primarily remote, with some travel required within Massachusetts....Remote job
- ...Description Physician Peer Reviewer – Multiple Specialties in Texas... ...Organization (IRO) with Health Utilization Management (HUM) accreditation... ...Medicine, Developmental-Behavioral Pediatrics, Pediatric Emergency... ...reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
- ...Program Company Overview Mental Health Resource Center is a not-for-profit... ...a wide range of mental health and behavioral health care services to the... ...Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical...Full timeMonday to FridayFlexible hours
$86k - $154.7k
...for the Psychologist Reviewer role at RemoteWorker US... ...our Medical Management/Health Services team. Centene... ...Centene is hiring a Remote Psychologist - Join Our... ...for improving access to behavioral health care? Centene... ...well as participating in Utilization Management clinical...Remote workFull timeWork at officeRelocation packageFlexible hours- ...corresponding level of care utilizing evidence-based criteria. Responsibilities... ..., and Case Management. Reviews the appropriateness of... ...Collaborates with family, health care team, payors, and... ...Partners-in-Caring process and the behavioral expectations in all interactions...Contract workWork experience placementFlexible hours
- ...Associates! *Must have Mental Health and/or Substance Abuse... ...Holidays ~ Work-life balance. ~ Remote setting ROLE DESCRIPTION: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workTemporary workWork at officeWork from homeMonday to FridayFlexible hours
$65k - $88.6k
...Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses behavioral... ...Experience with utilization review process. Experience with behavioral... ...Additional Information Workstyle: This is a remote position. Workdays & Hours: Monday...Remote workWeekly payFull timeTemporary workApprenticeshipPrivate practiceWork at officeWork from homeHome officeMonday to Friday$27.02 - $48.55 per hour
...our Medical Management/Health Services team. Centene... ...Performs a clinical review and assesses care related... ...concurrent review of behavioral health (BH) inpatient... ...quality and appropriate utilization of services... ...approach to work with remote, hybrid, field or office...Remote workHourly payFull timeContract workPart timeWork at officeFlexible hours
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