Remote Behavioral Health Utilization Specialist (RN/SW/PSY)
Humana Inc
- Remote job
Humana, Inc. is seeking a Licensed Behavioral Health Utilization Management Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations in a remote Louisiana-based role. The position requires a Louisiana license or equivalent behavioral health credentials and 3+ years of post-degree clinical experience. The role emphasizes independent decision-making, policy interpretation, and cross-system collaboration for member care. #J-18808-Ljbffr Humana Inc
- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining... ...ideal candidate has prior utilization review or behavioral health experience, strong knowledge of payer...Remote workPart timeWeekend work
- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior... ...necessity criteria while working remotely. Key responsibilities Verify insurance...Remote workFull time
$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity... ...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- Optum is seeking a Behavioral Health Utilization Review Specialist to support case management and care coordination remotely. You will review cases, determine levels of care, and coordinate transitions between inpatient and outpatient settings. You will collaborate with...Remote jobMonday to Friday
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...strong team-oriented environment. Requirements include active RN or LVN licensure, a minimum of two years in utilization review...Remote workWork at office
- ...Ambetter members in Georgia. This fully remote role follows a Monday-Friday schedule 8am... ...necessary care decisions. The position requires RN/LPN licensure with nursing education and... ...acute care experience; knowledge of utilization management is preferred. This role offers...Remote jobMonday to Friday
- Sanford Health in Sioux Falls, SD is seeking a Registered Nurse to conduct level of care medical necessity reviews within patient records. You will perform utilization management activities to assure compliance with accreditation and regulatory requirements, and support...Remote job
$65k - $88.6k
...of our caring community**The Licensed Behavioral Health Utilization Management Professional 2 uses behavioral... ...action:* Licensed Registered Nurse (**RN**) - Multi-State Compact**OR*** **... ...to troubleshoot and resolve within a remote environment **Preferred Qualifications...Remote workWeekly payFull timeTemporary workHome officeMonday to Friday- ...to support patient admissions. Candidates must have a valid California RN license and at least two years of clinical experience or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills. #J-1...Remote work
- ...Job Description Job Description Behavioral Health Utilization Management Specialist Location: Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health / Utilization Management Who We Are At Row Partners , we’re...Remote workFull timeWork at office
$62k - $70k
...Why Charlie Health? Millions of people across the country are... ...that lacks personalization, behavioral healthcare can leave people feeling... ...is to ensure that the utilization process is thorough, organized... ...Health‑sponsored benefits. #LI-REMOTE Please note that this role...Remote workFull timeLocal area$36 per hour
...employees. Position Summary: The Behavior Intervention Specialist (BIS) will assess and monitor... ...people with respect and dignity and to utilize person centered supports designed to... ...documented on the agency's electronic health platforms, i.e. PrecisionCare and Power...Remote workLocal area- ...matters Mesa Springs is part of Lifepoint Health, a diversified healthcare delivery... ...exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a... ...about Mesa Springs Mesa Springs is a behavioral health hospital offering exceptional...Temporary workPart timeRelief
- ...Brynn Marr Hospital in Jacksonville, NC seeks a Utilization Reviewer to assess patient records, determine appropriate levels of care... ...psychology, sociology, social work, or related fields. Monday–Friday day shift, fast-paced behavioral health environment. #J-18808-Ljbffr...Monday to FridayDay shift
- ...Mesa Springs is part of Lifepoint Health, a diversified healthcare delivery network... ...exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a... ...about Mesa Springs Mesa Springs is a behavioral health hospital offering exceptional...Temporary workPart timeRelief
- ...clinician to review ABA services and health status across the care... ...and alignment with behavioral health guidelines. The role involves... ...reviews, data analysis to improve utilization, and collaboration with BH... ...CST is required, with flexible remote/hybrid options. #J-18808-...Remote workFlexible hours
$26.41 - $51.49 per hour
...provide prior authorization for behavioral health services for the OH Medicaid... ...or previous experience with Utilization Reviews.WORK SCHEDULE:... ...alternative work schedule. This is a remote position. Home office with... .... • Registered Nurse (RN). License must be active and...Remote workHourly payWork experience placementWork at officeHome officeMonday to Friday- ...Description Job Description Utilization Review Specialist Job Description Unique... ...and most comprehensive behavioral services provider specializing... ...service or behavioral health with two (2) years experience... ...have LPCC, LSW, LCDC III or RN. Utilization Review...
$50 per hour
...Behavioral Health Utilization Management Specialist Location: Remote Type: Contract To Hire Compensation: $50 per hour Responsibilities Perform prospective, concurrent, and retrospective reviews for authorization, appropriateness of care determination, and benefit...Remote workHourly payContract workWork at officeLocal area- BHH Specialist: Behavioral Health Home - 7002 Job Category: Direct Care Requisition Number: BHHSP007002 Posted... ...with their clients. Flexible Work Style : Remote day potential and collaborative, learning-oriented atmosphere. Utilize a company vehicle to visit clients in...Remote workFull timePart timeLocal areaRelocation packageMonday to FridayFlexible hours
$22 - $27.14 per hour
...Job Shift: Day, Job Category: Health Care, Patient Experience Specialist (PES) II-Behavioral Health - Full Time Service Area... ...our clinics in our service area. Remote work is not available at this... ...eligibility requirements commonly utilized in nonprofit healthcare...Remote workHourly payFull timeContract workTemporary workSummer workImmediate startFlexible hoursShift work- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical... ...in a relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including medical...Remote workContract workWork from home
- ...an Appeals and Grievances Clinical Specialist to manage member complaints and clinical... ...case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities... ...clinical practice and knowledge of Utilization Review Guidelines. The position...Remote work
- Medusind in Costa Mesa, CA is seeking an UR Representative to conduct Utilization Reviews ensuring proper authorization for behavioral health services. You will review cases across multiple platforms, coordinate peer reviews, and enter authorization data while maintaining...
- Skyway Behavioral Healthis an innovative center that goes beyond the treatment of mood... ...for all patients. Role Description Utilization Review Specialist (URS) reports to the Utilization Review... ...services and documented mental health needs. Demonstrates a high level of accuracy...Temporary workLocal area
- Blue Cross and Blue Shield of Louisiana is seeking a Behavioral Health Utilization Reviewer to conduct clinical reviews ensuring medical necessity and appropriateness of care for behavioral health services. You will apply InterQual and medical policy criteria and coordinate...
- ...Inova Behavioral Health Services is looking for a dedicated Registered Nurse... ...work schedules, and remote and hybrid career opportunities... ...Heart Association required RN licensed, and eligible to practice... ..., Case management or utilization review preferred #J-18808-Ljbffr...Remote workFull timeMonday to FridayFlexible hoursShift workDay shift
$102k - $114k
...Overview RN Pysch / Registered Nurse, Home Health Location: Culver City Position: RN Psych... ...Position Type: Full Time Remote/Virtual Position: No Coverage... ...under physician's orders utilizing nursing theory, skills... ...Intermediary, the resume of the Behavioral Health/Psychiatric Home...Remote workFull timeFlexible hours- A healthcare coding firm is seeking Remote Outpatient/Behavioral Health Coders. Responsibilities include assigning diagnosis and CPT codes for various outpatient services, ensuring compliance with federal and state regulations. Candidates must have at least 3 years of coding...Remote work
$23 - $25 per hour
...A leading behavioral health services provider is seeking a Cash Application Specialist to join their remote team. The ideal candidate will have a minimum of one year of physician billing experience, strong communication skills, and the ability to manage their workflow...Remote workHourly pay
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