Remote Behavioral Health Utilization Review Clinician
Centene Corporation
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 of care.
It requires licensure (LCSW/LMHC/ LPC/LMFT/LMHP or RN) and relevant behavioral health credentials. Strong communication with providers, leadership, and health plans is essential, with opportunities to educate teams and
#J-18808-Ljbffr- ...Centene Corporation seeks a Behavioral Health Utilization Review professional to perform clinical reviews and assess the appropriateness of mental health and substance use services. This fully remote role supports Ambetter / Marketplace, reviewing requests for inpatient...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
- ...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 nationwide...Remote workFull timeDay shift
- ...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 work
$27.02 - $48.55 per hour
...About This Role The Utilization Review Clinician - Behavioral Health performs clinical reviews and assessments related to mental health and substance abuse... ...provided are medically appropriate. This fully remote role supports Oregon Medicaid and is ideal for candidates...Remote workFull timeWork at officeFlexible hoursDay shift$27.02 - $48.55 per hour
...Performs a clinical review and assesses care... ...to mental health and substance abuse... ...Details: This fully remote role supports the... ...by reviewing behavioral health authorizations... ...and have prior utilization management or review... ...health clinicians required. Clinical...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...Comagine Health is seeking a remote clinical reviewer to support behavioral health services across Oregon. You will evaluate documentation for medical necessity, conduct functional needs assessments, and coordinate home and community-based care. You will manage referrals...Remote workWork from home
- ...Centene Corporation offers a fully remote role focused on reviewing behavioral health authorizations for inpatient, residential treatment, and partial hospitalization. The schedule is Monday through Friday, 8-5 pm Eastern or Central, with preference for candidates in...Remote workMonday to Friday
$64k - $95k
...Valley Hope in Overland Park/Leawood, KS is seeking a full-time Utilization Review Clinician. This role can be performed remotely by candidates in Valley Hope locations. You will review and coordinate clinical utilization, determine admission appropriateness, report...Remote workFull time- Centene Corporation seeks a remote Behavioral Health reviewer to support the Texas Ambetter Inpatient Behavioral Health population. The role requires 4 x 10-hour shifts weekly with Saturday availability; weekend differential is offered. You will evaluate care, perform prior...Remote jobShift workWeekend work
- ...Spectraforce Technologies, Inc. is seeking a Utilization Review Clinician - ABA to manage a large caseload, conduct monthly outreach, and coordinate... ...and CRM systems. Required BCBA certification and Licensed Behavior Analyst credentials, plus 2–4 years of related experience....Remote work
- ...Title: Utilization Review Clinician - ABA Duration: 3 Months - Contract-to-Hire Location: Remote - GA Mon-Fri | 8A-5P EST Position Summary... ...to support positive health and care outcomes. Participate... ...: BCBA - Board Certified Behavior Analyst Preferred:...Remote workContract work
- ...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
$71.14k - $115.86k
...Behavioral Health Utilization Management Clinician Work from home within Oregon, Washington, Idaho or Utah Preference... ...concurrent and retrospective review) to best meet the member’s specific... ...data protection and integrity. #LI-Remote Pay ranges vary based on the...Remote workFull timeWork at officeImmediate startWork from homeFlexible hours$27.02 - $48.55 per hour
...Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services... ...: This is a remote position, but applicants... ...quality and appropriate utilization of services... ...for behavioral health clinicians required. Behavioral...Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete... ...support medical necessity criteria while working remotely. Key responsibilities Verify insurance...Remote workFull time
- ...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 is recruiting a remote Behavioral Health Utilization Review Specialist to support case management for behavioral health and substance use. You will review cases, determine levels of care, and coordinate transitions between inpatient and outpatient settings. This...Remote workFull timeMonday to Friday
- ...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
- ...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
$54.1k - $116.76k
...We’re building a world of health around every individual — shaping... ...one community at a time. Behavioral Health Precertification / Utilization Management Clinician 100% Remote | Monday–Friday | 12:00 PM –... ...and play a critical role in reviewing behavioral health...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayWeekday work$54.1k - $142.58k
...We’re building a world of health around every individual — shaping a... ...and one community at a time. Behavioral Health Utilization Management Clinician 100% Remote | Nationwide | Shift Differential... ...included What You'll Do Review preauthorization requests for...Remote workHourly payFull timeTemporary workLocal areaShift workNight shiftWeekend work- ...Blue Shield of CA is seeking a Behavioral Health Utilization Management Clinician, Senior, to conduct clinical reviews of mental health and substance use authorization requests across levels of care. This role supports medical necessity, coding accuracy, and policy compliance...Work at office
- ...TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services. Responsibilities include preauthorization...Remote work
- ...Humana is seeking a Licensed Behavioral Health Utilization Management Professional 2 to coordinate, document, and communicate medical services and determinations for members. This remote role requires a Louisiana-resident license setup and extensive behavioral health expertise...Remote work
- ...seeking a Registered Nurse for a remote role with Arizona hours (1st shift). You will review medical records for quality, safety, and utilization issues, identify PQIs, and support... ...clinical experience in med/surg or behavioral health, and be eligible for DoD background...Remote workDay shift
- NOXNOX is seeking an Assessment & Utilization Review (UR) Clinician in Ohio to conduct comprehensive behavioral health and substance use disorder intake assessments. The role coordinates insurance authorizations to ensure appropriate level of care and medical necessity...
- Centene Corporation is seeking a remote Behavioral Health RN reviewer to assess care related to mental health and substance use disorders. You will participate in weekend/holiday rotations and must hold an RN license active in Washington or a compact state. You will evaluate...Remote jobWeekend work
- ...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
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