Remote Utilization Review Specialist - Behavioral Health
Santa Barbara Cottage Hospital
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 focus on compliance and patient privacy. The position requires ASAM knowledge, medical terminology proficiency, and familiarity with state and federal confidentiality laws. #J-18808-Ljbffr
$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$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- ...FHE Health Job OpportunityFHE Health is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...are seeking an experienced specialist who is passionate about... ...required preferred.2-3 years of utilization review experience in behavioral...Remote workDaily paidFull time
- Nationwide Children’s Hospital is seeking a Behavioral Health Utilization Review Specialist to review cases, determine medical necessity, and ensure compliance with guidelines. The role conducts pre-certifications, pre-authorizations, and retrospective reviews, collaborating...Remote jobWork at officeWork from home
$41.6k - $47k
...Utilization Review SpecialistAt Umpqua Health, we're more than a healthcare organization we're... ...primary care, specialty care, behavioral health services, and... ....The Utilization Review Specialist supports Umpqua Health... ...organized and productive in a remote, independent work...Remote workWork at officeLocal areaImmediate startMonday to FridayShift work$51 per hour
...Utilization Review Specialist (BCBA Licensee) Baltimore, MD (Remote – offsite) Contract To Hire $51/hr (W2) 100% Remote Must be... ...and appropriateness of Applied Behavior Analysis (ABA) services. This... ...mandates, and medical/behavioral health policies to support...Remote workContract workWork at officeWork from home$51 per hour
...Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote – offsite) Type: Contract To Hire Compensation... ...appropriateness of Applied Behavior Analysis (ABA) services.... ..., and medical/behavioral health policies to support determinations...Remote workContract workTemporary workWork at officeLocal areaWork from home$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- ...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
$39.4 - $53 per hour
...revenue cycle management solutions for health systems, including hospitals and... ...other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job... ...and Abilities Required: This is a remote role which requires access to high speed...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend work- ...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
$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team.This role is ideal for an RN with strong experience in OASIS, coding, QA, and home health...Remote workMonday to FridayWeekend work- HonorHealth is seeking a Utilization Review RN Specialist to review and monitor health care utilization, ensuring medical necessity and appropriate levels of care... ...driving accurate documentation for data reporting. Remote work is available after training, with a day shift...Remote jobDay shift
- Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote job
- 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...
- 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
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity, coordinate with physician advisors, and collaborate with care management and financial clearance teams to ensure high-quality patient care and appropriate...Remote job
- ...Remote Authorization SpecialistThis role manages... ...certifications, concurrent reviews, verifying benefits,... ...by a payer issue.Utilization Review · Insurance Authorization... .../Precertification · Behavioral Health Case ManagementVerify... ...a UR/authorization specialist at the PHP and IOP...Remote work
- ...ABA Behavior Health Associate Position is Home Based. Under the direction of IBT Coordinator... ...the patient care planning &treatment review process under the direction of the Clinical... ...in a safe, effective manner, utilizing the least restrictive, safe patient care...Remote workWork from homeShift work
$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- ...Utilization Review Specialist The primary purpose of the Utilization Review Specialist is to create... ...field, the insurance field or in the behavioral health field preferred A minimum of two... ...CORI and background check. Satisfactory drug screen Part Time Remote Role...Remote workPart timeWork at officeFlexible hours
$27.02 - $48.55 per hour
...our Medical Management/Health Services team. Centene... ...Texas Outpatient Behavioral Health Experience Position... ...Performs a clinical review and assesses care... ...quality and appropriate utilization of services... ...approach to work with remote, hybrid, field or office...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...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 workContract workWork from home
- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail... ...facing substance use and mental health disorders. Backed by TPG, one of the... ...environmentPreferred:Graduate degree in a health or behavioral health related fieldClinical...Remote workTemporary work
- ...manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR... ...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
- ...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 SpecialistAs a Behavioral Health Specialist, you will be part of an integrated care team... ...opportunities for both remote and on-site work.Professional... ...use disorders.Utilizes evidence-based treatment... ...policies.Participates in peer review processes, agency...Remote workWork at officeFlexible hours
- Molina Healthcare is seeking a Registered Nurse with an OH or compact license to join the Care Review Clinician team. You will provide prior authorization for behavioral health services for the Ohio Medicaid population and support member care across the continuum. Key...Monday to Friday
- ...tasks related to preadmission reviews, continued stay reviews,... ...least restrictive environment, utilizing proven clinical interventions... ...Screening for co-occurring mental health conditions. Supports... ...leadership. Workplace Behaviors Demonstrates the ability...Remote workWork at office
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