Remote Utilization Review Manager - Behavioral Health
KVC Health Systems, Inc.
- Remote job
KVC Health Systems, Inc. is seeking a detail-oriented Utilization Review Manager (URM) to serve as a key link between treatment teams, funding sources, and external partners. This remote statewide Missouri role focuses on obtaining and reviewing clinical and medical service authorizations to support high-quality behavioral healthcare for children and families. The URM will collaborate with admissions and clinical teams, analyze data to support treatment recommendations, and ensure compliant #J-18808-Ljbffr KVC Health Systems, Inc.
- KVC Health Systems, Inc. in Kansas City, MO is seeking a dedicated Utilization Review Manager (URM) to obtain and review clinical and medical service authorizations, supporting high-quality behavioral healthcare for children and families. You will liaise with treatment...Remote job
- ...Community Health Choice is seeking a Behavioral Health Utilization Manager with nursing credentials to conduct concurrent and discharge reviews using established criteria for admission and ongoing... ...psychiatric/managed care settings, with remote work arrangements and strong...Remote work
- ...Centene Corp. is seeking an Utilization Review Clinician - Behavioral Health to conduct clinical reviews for mental health and substance use services, ensuring... ...level of care for Oregon Medicaid in a fully remote role. The position follows a Monday–Friday 8–5 Pacific...Remote workMonday to Friday
- ...Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on... ..., communicating with managed care organizations, and collaborating... ...has prior utilization review or behavioral health experience, strong knowledge...Remote workPart timeWeekend work
- ...Centene Corporation is seeking a fully remote Behavioral Health Utilization Review Specialist. The role focuses on evaluating mental health and substance use care, performing prior-authorizations, and conducting concurrent reviews to ensure medically appropriate levels...Remote work
- ...Centene Corporation is seeking a remote Behavioral Health Utilization Review Specialist to assess care for mental health and substance use, reviewing authorization requests and inpatient cases across various settings. The role emphasizes collaboration with providers, medical...Remote work
- ...Centene is seeking a remote Utilization Review Clinician - Behavioral Health to support Oregon Medicaid. The role requires independent clinical licensure and... ...experience in behavioral health and utilization management. It offers a full-time day-shift schedule and a...Remote workFull timeDay shift
- ...Centene Corporation is seeking a remote Behavioral Health Utilization Review Nurse/Clinician to assess care for mental health and substance abuse. Role supports the California Market with flexibility for other states, working Mon-Fri Pacific time. Licensure as required...Remote work
- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations,... ...necessity criteria while working remotely. Key responsibilities Verify insurance...Remote workFull time
- ...is seeking a Medical Director, Concurrent Review, to evaluate hospitalizations nationwide.... ...and provide expert recommendations. This remote position offers a predictable schedule and a path to expand knowledge in Utilization Review. Ideal candidates hold an MD/DO...Remote work
- ...Comagine Health in Oregon seeks a Clinical Reviewer to evaluate medical necessity and appropriateness of behavioral health services. You will review clinical... ...documentation, perform utilization reviews, and document... ...youth, and adults. This remote, Oregon-based role...Remote work
- ...seeking a Medical Director to lead inpatient medical necessity reviews and utilization management with a focus on quality and physician collaboration. The... ...cases and support Humana’s care standards. This remote position requires MD or DO, board certification, and a valid...Remote work
- ...COMAGINE HEALTH is seeking a remote utilization review clinician based in Oregon to evaluate medical necessity for behavioral health services. The role involves reviewing clinical documentation, performing initial and continued stay assessments, and coordinating care...Remote work
- Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assess care for mental health and substance use. This remote role supports clinicians across the continuum of care while collaborating with providers to determine appropriate...Remote job
- ...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 workWork from home
- Centene Corporation is seeking a remote Behavioral Health Clinical Reviewer to support Oregon Medicaid. The role conducts clinical reviews for mental... ...leadership to ensure appropriate levels of care and efficient utilization of services. Required qualifications include a...Remote job
$71.03k
...AHCCCS Arizona Health Care Cost Containment System... ...environments including remote work opportunities. With... ...and dedicated team. Behavioral Health Prior Authorization Utilization Review Consultant Division of Fee for Service Management (DFSM) Job Location:...Remote workFull timeContract workPart timeInternshipWork from homeFlexible hours$27.02 - $48.55 per hour
## Utilization Review Clinician - Behavioral HealthApply: Remote-OR: Full time: Posted Today: 1666128**Position Purpose:** Performs... ...care related to mental health and substance abuse. Monitors and... ...health and (3) utilization management or review experience. * Evaluates...Remote workHourly payFull timeMonday to Friday- Centene is hiring a Utilization Review Clinician - Behavioral Health for a fully remote position, serving members nationwide with a focus on mental health and substance abuse utilization management. The role emphasizes clinical reviews, prior authorizations, and data-driven...Remote job
- Centene Corporation is seeking a remote Behavioral Health Utilization Review Clinician for the California Market. The role supports a Monday-Friday schedule... ...hours. Preferred candidates have BH utilization management experience and relevant licenses. Responsibilities...Remote jobMonday to Friday
- 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
- The Behavioral Health Prior Authorization Utilization Review Consultant monitors, evaluates, and approves or denies payment... ...is located in Phoenix with remote work options available and is part... ...the Division of Fee for Service Management. Key qualifications: Current Arizona...Remote work
- Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assessments related to mental health and substance use... ...and medically necessary. Based in Louisiana, this remote, full-time role offers day shifts, competitive pay, and...Remote jobFull timeDay shift
- 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
- ...WellSense Health Plan, a Massachusetts-based nonprofit health insurer, is seeking a Behavioral Health Utilization Manager. This role requires clinical judgment to assess outpatient behavioral... ...with standards. The role supports remote work, offers competitive pay, and...Remote work
$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role Principles Recovery... ...hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent and adult...Remote workFull timeMonday to Friday$29.1 - $62.32 per hour
We’re building a world of health around every individual — shaping... ...one community at a time. Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) 100% Remote | Florida Residents Only | Monday... ...utilization. What You'll Do Review treatment plans, clinical...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shift$27.02 - $48.55 per hour
...About This Role The Utilization Review Clinician - Behavioral Health performs clinical reviews and assessments... ...medically appropriate. This fully remote role supports Oregon Medicaid and... ...behavioral health and utilization management. Highlights Pay: $27.02 -...Remote workFull timeWork at officeFlexible hoursDay shift- ...Northpoint Recovery Holdings, LLC is seeking a licensed Utilization Review Specialist to ensure clinically appropriate care, discharge planning, and cost-effective utilization across the treatment continuum. You will lead reviews of admissions, stays, discharges, and...Remote work
- WellSense Health Plan is seeking a Behavioral Health Utilization Manager to oversee outpatient and non-24 hour diversionary services. You will be a key clinical decision... ...a proactive, analytical approach. This primarily remote role involves collaboration with Medical Directors...Remote job
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