Behavioral Health Utilization Review Specialist (Remote)
Humana Inc
- Remote job
Humana Inc. is seeking a Utilization Management Behavioral Health Professional for remote roles across several states. You will perform clinical reviews of behavioral health prior authorizations, coordinate with medical directors, and document all decisions in the system. The position emphasizes adherence to regulations, quality assurance, and ongoing education of providers. A licensed BH professional with post-degree experience is required, with bilingual skills considered a plus. #J-18808-Ljbffr Humana Inc
- ...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 work
$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity... ...pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the... ...Qualifications) Bachelor’s degree in a health or behavioral health-related field required...Remote work- Humana Inc. is seeking a Utilization Management Behavioral Health Professional for remote roles across several states. You will perform clinical reviews of behavioral health prior authorizations, coordinate with medical directors, and document all decisions in the system...Remote job
$55k - $70k
...hands-on, process-driven operational support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000... ...must have prior UR & clinical experience. Remote hires and applicants without prior...Remote workFull timeWork at office$41.6k - $47k
...Utilization Review Specialist At Umpqua Health, we're more than a healthcare organization we're a community-driven... ...primary care, specialty care, behavioral health services, and care coordination... ...organized and productive in a remote, independent work environment...Remote workWork at officeLocal areaImmediate startMonday to FridayFlexible hoursShift work$27.07 - $33.37 per hour
Bakersfield Behavioral Healthcare Hospital in Bakersfield, California, seeks a Utilization Review Specialist to review medical records, prepare clinical appeals, and coordinate certifications with managed care. Requires High School Diploma, current California LVN license...Hourly pay$51 per hour
Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote - offsite) Type: Contract To Hire Compensation:... ...and appropriateness of Applied Behavior Analysis (ABA) services. This... ..., and medical/behavioral health policies to support determinations...Remote workContract workWork at officeLocal areaWork from home- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
- ...Job Description Job Description Behavioral Health Utilization Management Specialist Location: Utah (Hybrid & Remote Options Available) Job Type: Full-time Department... ...You’ll Do Champion patient care by reviewing medical records and clinical documentation...Remote workFull timeWork at office
- Centene is seeking an Utilization Review Clinician for Behavioral Health. The role focuses on clinical reviews and evaluating care related to mental health and... ...a strong impact on patient care. The position offers remote work options with a daytime schedule and full-time...Remote jobFull time
$65k - $88.6k
Humana is seeking a Behavioral Health Utilization Management professional to support clinical reviews for prior authorizations. The role requires IL-licensed clinicians with... ...health and utilization review processes. Remote work with occasional travel to Humana offices...Remote jobWeekly pay- Evolve Treatment Centers in West Palm Beach, Florida, is seeking a full-time Utilization Review Specialist. This role involves initiating pre-certification authorizations, communicating with facilities, and maintaining patient census. Candidates should have a High School...Full time
- Memorial Physician Practices is hiring a Utilization Review Specialist in Tucson, Arizona, who will facilitate clinical reviews and advocate for patients accessing mental health services. This PRN role involves working with managed care organizations and is vital for ensuring...Relief
- Northwestern Memorial Healthcare is seeking a Utilization Reviewer to join their team. Responsibilities include managing utilization review calls, advocating for patients with insurance companies, and coordinating efforts to appeal unfavorable decisions. The ideal candidate...
$29.62 - $45.31 per hour
...Description Providence Health Plan caregivers are not simply valued – they’re invaluable... ...Department Coordinate and execute the review and research functions required to... ...inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...purpose-driven leadership. At Bradford Health Services, we are committed to... ...digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching... ...people. About the Role: The Utilization Review Specialist plays a critical role in ensuring...Remote workPart time
- ...Behavioral Health Specialist As a Behavioral Health Specialist, you will be part... ...with opportunities for both remote and on-site work.... ...substance use disorders. Utilizes evidence-based treatment models... ...policies. Participates in peer review processes, agency audits,...Remote workWork at officeFlexible hours
$27.02 - $48.55 per hour
...on our Medical Management/Health Services team. Centene is a... ...Oklahoma Complete Health - Behavioral Health Utilization Management Training Schedule... ...: Performs a clinical review and assesses care related to... ...flexible approach to work with remote, hybrid, field or office...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...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 workFlexible hours
- ...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
- ...Treatment Alternative Centers is looking for a Utilization Review Specialist in Chadds Ford, PA. This role supports behavioral health programs, ensuring services are medically... ...management. This position offers flexible hybrid or remote work options and a comprehensive benefits...Remote jobFlexible hours
- ...ABA Utilization Review Specialist Spectrum Billing Solutions offers industry-leading revenue cycle... ...environment. This is a fully remote or office/home hybrid position.... ...~3-5 years of related ABA and/or Behavioral Health experience. ~ Bachelor's or master...Remote workWork at officeFlexible hours
- ...facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The... ...or a Master's degree in a related field. The position offers remote work with emphasis on critical thinking and problem-solving skills...Remote work
- ...Utilization Review Specialist | Remote | Full-Time Banyan Treatment Centers is seeking an experienced and... ...individuals facing substance use and mental health disorders. Backed by TPG, one of... ...Graduate degree in a health or behavioral health related field Clinical...Remote workFull timeTemporary work
- Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based... ...relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including...Remote jobContract workWork from home
$19.5 - $26.48 per hour
Job Description:The Behavioral Health Specialist (BHS), under the direction and supervision... ..., etc.Expected to lift and utilize full range of movement to... .... If applying for a remote or hybrid role, this includes... ...HiredScore assists in reviewing applications, all final decisions...Remote workHourly payWork experience placementImmediate start- Utilization Review (UR) Specialist Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday Overview Diversified Treatment... ...Review (UR) Specialist to support our behavioral health programs. This role plays a critical part...Remote workFull timeMonday to FridayFlexible hours
- NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals... ...Medical Director to support timely decisions and effective patient care across a multi-site health plan. #J-18808-Ljbffr NeighborHealthRemote job
- 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 degree...Remote job
$17.44 per hour
...Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E. Integrity, Compassion, Accountability,... ...because we care! About the Position: Tulsa Center for Behavioral Health is recruiting a Utilization Review Specialist. This position...Hourly payFull timeWork at officeFlexible hoursWeekend work
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