Remote Utilization Review Specialist, Behavioral Health
Gosnold
Gosnold in Wareham, MA seeks a Utilization Review Specialist for a remote, full-time role (40 hours, 8a-4p). The position focuses on pre-certification and concurrent clinical utilization reviews with insurers, ensuring patient coverage and collaboration with Patient Financial Services. Candidates should have a bachelor’s degree in nursing, social work, psychology, mental health or addiction, plus two years of clinical experience and knowledge of clinical criteria for levels of care. #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Utilization Review Specialist, Behavioral Health in Wareham, MA vacancy
- ...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
Recovery Unplugged
United States3 days ago - ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant... ...optimization, compliance, and high-quality patient care across behavioral health services. #J-18808-Ljbffr...Remote work
The Florida House
New York, NY5 days ago - ...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
Virtual Vocations Inc
United States5 days ago - ...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...Remote workMonday to Friday
Optum
Phoenix, AZ5 days ago - ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...Remote work
State of Arizona
New York, NY5 days ago - ...Optum is seeking a remote Behavioral Health Utilization Review Specialist to support case management and care coordination. This full-time, Monday–Friday role offers standard business hours with occasional on-call needs based on business requirement. The position requires...Remote workFull timeMonday to Friday
Optum
United States22 hours ago - ...Technologies LLC is seeking a detailed clinical reviewer to adjudicate Behavioral Health prior authorizations. You will assess... ...health services. Role emphasizes utilization review and QA with no direct patient contact, offering 100% remote work, full-time hours, and...Remote workFull time
Gainwell Technologies LLC
United States2 days ago $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 Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...Remote workFull timeMonday to FridayPrinciples Recovery Center
United States2 days ago$90.9k - $129.9k
...Apply your expertise to adjudicate Behavioral Health prior authorizations based on medical... ...for this role, rather you will provide utilization review and quality assurance. Your role in... ...expect in this role ~100% Remote home office. ~ Full-time position...Remote workFull timeWork experience placementHome officeFlexible hoursGainwell
Madison, WI3 days ago- ...monitoring the Mental Health Plan and Drug-Medi-... ...-ODS), including review of medical records to ensure proper utilization of treatment... ...clients receiving behavioral health treatment. UR Specialists also interpret, advise... ...option for hybrid remote work may be available...Remote workContract workLocal areaTrial periodFlexible hours
santacruzcountyca.gov
Santa Cruz, CA2 days ago - ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
Hansei Solutions
United States4 days ago - ...Kent County Cmh Authority is seeking a Utilization Review Specialist to perform reviews for I/DD, mental health, and SUD services. You will assess treatment plans and... ...intensity settings. The role is full-time and remote with occasional local travel within the Kent...Remote workFull timeLocal area
Kent County CMH Authority
Grand Rapids, MI3 days ago - ...CVS Health is hiring a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana-preferred location. You will review services, coordinate decisions, provide crisis triage, and support transitions of care while ensuring evidence-based treatments...Remote work
CVS Health
United States6 days ago - ...CVS Health is seeking a Behavioral Health Utilization Management Clinician to join the remote Utilization Management team. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services...Remote work
CVS Health
United States4 days ago - ...About Us FHE Health ("FHE") is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...We are seeking an experienced specialist who is passionate about making... ...preferred. 2-3 years of utilization review experience in behavioral health...Remote workDaily paidFull time
The Florida House
United States4 days ago - ...SummitRidge Hospital in Lawrenceville, GA, part of Universal Health Services (UHS), is seeking a PRN Utilization Review Coordinator to support behavioral health services on an as-needed basis. You will coordinate utilization review activities, secure timely insurance...Relief
Universal Health Services
Lawrenceville, GA4 days ago - ...Pavilion Behavioral Health System in Champaign, Illinois, is seeking a Full-time Utilization Review Coordinator to ensure accurate chart reviews and to obtain hospital stay certifications from insurers. The role supports behavioral health and addiction treatment across...Full time
Laurel Ridge Treatment Center
Champaign, IL1 day ago - ...New Vista Behavioral Health is seeking a detail-oriented Corporate Utilization Review Specialist to support utilization review and insurance authorization processes across multiple behavioral health facilities. Candidates must hold an active clinical license as an...
New Vista Behavioral Health
Cincinnati, OH2 days ago $48.78 - $73.17 per hour
...interested in joining Sutter Health! Organization ABSMC-Alta Bates... ...continued stay, and proper utilization of physician, nursing, and ancillary... .... Responsible for concurrent review on specific patients.... ...REQUIRED EDUCATION Department, Behavioral Health: Master's in Social Work...Full timeWork at officeLocal areaMonday to FridayShift workWeekend workSutter Health
Berkeley, CA3 days ago- 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
$65k - $88.6k
...Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document, and communicate medical services... ...with providers and members to ensure optimal care. The remote position includes standard hours, occasional travel for...Remote workHumana
New York, NY6 days ago- ...Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and determinations for medical services and benefit administration. You will interpret criteria and policies and work with...Remote workWork at office
Humana
New York, NY1 day ago - ...Camber Connect in Olathe, KS seeks a detail-oriented Utilization Review Specialist to bridge clinical teams and health plans, managing initial, concurrent, and... ...day review, with 2 days in the office and 3 days remote. The role demands accuracy, urgency, and advocacy...Remote workWork at office
KVC Health Systems
Olathe, KS3 days ago - ...Centene Management Company LLC in Texas seeks a experienced Behavioral Health Utilization Reviewer to evaluate and authorize mental health and substance abuse care. The role requires compliance with regulatory guidance and collaboration with BH teams to ensure appropriate...Remote work
Centene Management Company LLC
United States2 days ago - ...Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication... ..., and collaboration with providers and members, in a remote setting. Requirements include a nursing degree or a...Remote workWork at office
Humana, Inc.
Denver, CO22 hours ago - ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
Sedgwick Claims Management Services
United States1 day ago - ...CVS Health is hiring a Behavioral Health Precertification/ Utilization Management Clinician to work remotely with a consistent weekday schedule. The role focuses on reviewing behavioral health authorization requests and ensuring appropriate levels of care using evidence...Remote workWeekday work
CVS Health
Central City, KY5 days ago - Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication... ..., and adherence to policy guidelines. This is a remote nationwide position with standard working hours and...Remote job
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Remote workWork at office
HealthHelp
United States1 day ago $69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote workFull timeCincinnati Children's
United States1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Utilization Review Specialist, Behavioral Health. Be the first to apply!
Related searches
- cybersecurity specialist Wareham, MA
- gaming specialist Wareham, MA
- fabrication specialist Wareham, MA
- international relations specialist Wareham, MA
- executive protection specialist Wareham, MA
- adoption specialist Wareham, MA
- transportation specialist Wareham, MA
- drug safety specialist Wareham, MA
- wildlife specialist Wareham, MA
- continuous improvement specialist Wareham, MA