Remote Utilization Management Behavioral Health Specialist
Humana, Inc.
Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role emphasizes clinical knowledge, independent judgment, and collaboration with providers and members, in a remote setting.
Requirements include a nursing degree or a Human Services master's with Kentucky licensure, 3+ years clinical experience, and proficiency in Microsoft Office.
#J-18808-Ljbffr- ...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
$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 work- ...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
$90.9k - $129.9k
...your expertise to adjudicate Behavioral Health prior authorizations based... ..., rather you will provide utilization review and quality assurance... ...outcomes into the Medicaid Management Information System (MMIS)... ...in this role ~100% Remote home office. ~ Full-time...Remote workFull timeWork experience placementHome officeFlexible hours- 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
- Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to coordinate, document and communicate medical services and benefit determinations. The role requires clinical judgment, strong communication, and independence, with travel...Remote jobFull timeWork at office
- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior authorizations, and... ...necessity criteria while working remotely. Key responsibilities Verify...Remote workFull time
- ...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
- ...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
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications... ...compliance, and high-quality patient care across behavioral health services. #J-18808-Ljbffr...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...Remote workMonday to Friday
- ...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
- ...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
- ...a detailed clinical reviewer to adjudicate Behavioral Health prior authorizations. You will assess medical... ...mental health services. Role emphasizes utilization review and QA with no direct patient contact, offering 100% remote work, full-time hours, and opportunities...Remote workFull time
$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... ...are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent and adult...Remote workFull timeMonday to Friday- ...monitoring the Mental Health Plan and Drug-Medi-... ...to ensure proper utilization of treatment... ...clients receiving behavioral health treatment. UR Specialists also interpret, advise... ...option for hybrid remote work may be available... ...regulations pertaining to managed care; laws and...Remote workContract workLocal areaTrial periodFlexible hours
- ...CVS Health is seeking an Utilization Management Clinical Consultant for a Work at Home CST role. You will apply clinical experience to assess treatment... .... This full-time position requires an independent Behavioral Health license (LA or Compact), 3+ years in...Remote workFull timeWork from homeFlexible hours
- ...monitor care plan implementation. Manage 1915(c) Waiver funds ensuring... ...deeper knowledge of behavioral health management skills. Primary Location Remote Department PS Network -... ...families’ needs as identified. Utilizing culturally competent and trauma...Remote workFull timeShift work
$46.76 - $51.76 per hour
...Behavioral Health Analyst Pay Range: $46.76hr - $51.76hr Requirement/Must Have: Masters... ...Standards and departmental SOPS to manage member assignments. Conducts research... ...Nice to Have: Prior experience in utilization management, care management, or payer-...Remote jobWork at office$53.19k - $82.43k
...annual award recognizes hospitals and health systems nationwide that have... ...What You Will Do in This Role: The Utilization Management Specialist provides advanced operational and workflow... ...current and complete. *Approved Remote States: Arizona, California, Colorado...Remote workFull time- ...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... ...’s degree in nursing, social work, psychology, mental health or addiction, plus two years of clinical experience and...Remote workFull time
- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating... ...with clinical staff to optimize authorization decisions, manage caseloads, and ensure accurate documentation while staying...Remote work
- ...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
$65k - $88.6k
...community Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge... .... Additional Information Workstyle: This is a remote position. Workdays & Hours: Tuesday - Saturday; 8:3...Remote workFull timeTemporary workApprenticeshipPrivate practiceWork at officeWork from homeHome office$18 - $24 per hour
...is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping... ...access, or RCM experience supporting behavioral health services is required. Experience... ...Range For This Role Is 18 - 24 USD per hour(Remote (United States)) #J-18808-Ljbffr...Remote workHourly pay- ...Trillium Health Resources is seeking an Utilization Management Specialist III - MH/SU to perform comprehensive clinical review of service requests for individuals... ...licensure; travel within the NC catchment is expected. Remote work options are available for many roles. #J-188...Remote work
- ...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
- ...Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will coordinate with providers and members...Remote work
- ...CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management to ensure appropriate care at the right time through evidence-based review and coordination. This role supports 24/7 operations and may require evenings, weekends, and holidays from a...Remote workWork from homeWeekend workAfternoon shift
- ...Employment type: Full-time Category: Behavioral Health, Behavioral Health - Support Staff,... ...UHS of Delaware, Inc. - Corporate Office - Remote; Fully remote; 40 Posted: Responsibilities Milieu Management Specialist Opportunity About Universal Health Services...Remote workFull timeWork at officeLocal area
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