Remote RN Utilization Review Clinician - Behavioral Health
Molina Healthcare
- Remote job
Molina Healthcare in Columbus, OH is seeking a Care Review Clinician to provide prior authorization for behavioral health services for the OH Medicaid population. The role requires strong BH care experience across inpatient, substance use, and outpatient services, plus excellent multitasking and analytical thinking. You will assess medical necessity, verify benefits and eligibility, and collaborate with medical directors and multidisciplinary teams to ensure cost-effective, quality member care. #J-18808-Ljbffr Molina Healthcare
- ...Centene Corporation is seeking a Behavioral Health Utilization Review clinician to evaluate and authorize BH services, ensure appropriate levels of care, and collaborate with providers and medical leadership. This role emphasizes quality improvement, case presentations...Remote work
$26.41 - $51.49 per hour
...complact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH... ...experience with Utilization Reviews. WORK SCHEDULE... ...schedule. This is a remote position. Home office... ...experience. Registered Nurse (RN). License must be...Remote workHourly payWork experience placementWork at officeHome officeMonday to Friday- ...Centene is seeking an Inpatient Utilization Review Clinician for Behavioral Health to perform clinical reviews and assessments ensuring appropriate care for... ...coordination of care across providers. The position offers remote flexibility with a 8am–5pm schedule on days (Tuesday-...Remote workWeekend 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
$27.02 - $48.55 per hour
...Performs a clinical review and assesses... ...to mental health and substance abuse... ...to work remotely from their home... ...concurrent review of behavioral health (BH) inpatient... ...appropriate utilization of services... ...behavioral health clinicians required.... ...) required or RN - Registered Nurse...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- 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
- ...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
- ...Corporation is seeking a clinical reviewer to assess mental health and substance use care, determine... ...necessity, and support appropriate utilization. Remote work within the Central Time Zone... ...required licenses, and a Master’s in behavioral health for #J-18808-Ljbffr...Remote jobMonday to Friday
- ...Centene Corporation seeks a remote Behavioral Health reviewer to support the Texas Ambetter Inpatient Behavioral Health population. The role requires... ...medically appropriate services. Requires nursing education (RN) with state licensure; master's in behavioral health...Remote workShift workWeekend work
$45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc... ...: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/1... ...Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities,...Remote workHourly payLong term contractPermanent employmentFull timeContract workTemporary workWork experience placementWork at officeMonday to FridayShift workWeekend work$38 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency... ...Nurse – Utilization Review (Remote) Location: Fort Myers, Florida Facility: Lee Health – Corporate Center... ...centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol...Remote workHourly payLong term contractPermanent employmentFull timeContract workTemporary workWork experience placementWork at officeMonday to FridayShift workWeekend work- ...diversified national organization is seeking a Licensed Clinical Behavioral Health Professional or RN to assess care related to mental health and substance... ...evaluating treatment needs, performing authorization reviews, and improving service quality. Ideal candidates should...Remote jobFlexible hours
- ...WellSense Health Plan in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity... ...teams. This fully remote, full-time role requires an active RN license, nursing... ...management to ensure timely reviews, document outcomes,...Remote workFull time
- ...Clinical Member Services Reviewer Provides support for clinical member services review... ...promote the Molina care model. Adheres to utilization management (UM) policies and procedures.... ...and experience. Registered Nurse (RN). License must be active and unrestricted...Work at office
$76.58k - $118.7k
...Who we are Community Health Plan of Washington is an... ...About the Role The Level I Utilization Management Clinician performs utilization review for medical or behavioral health requests using... ...unrestricted license as an RN or LPN. Have at least two...Full timeTemporary workPart timeWork at officeLocal areaTrial periodAll shiftsFlexible hours$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased... ...and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an... ..., Clinical Managers, and field clinicians Support quality assurance and...Remote workMonday to FridayWeekend workWeekday work- One of the largest health benefits companies... ..., dental, vision, behavioral health benefit... ...LTSS department. RN will be responsible... ...authorization and concurrent review. Provides monthly... ...setting by utilizing the applicable medical... ...Info: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
$45 - $50 per hour
...Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: Lancesoft Inc Pay: $45 to $50 per hour Shift Information... ...Management Location: Fort Myers, Florida – Fully Remote Duration: 13 weeks Start: 10/19/2026 Hours: 40 hours...Remote workHourly payFull timeContract workWork experience placementImmediate startMonday to FridayShift workWeekend 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
- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days Job... ...help patients achieve optimal health, access to care, and... ...years of acute hospital or behavioral health patient care experience... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
$50k
...Employer Industry: Behavioral Healthcare Management Why consider this job opportunity... ...pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the... ...) Bachelor’s degree in a health or behavioral health-related field required...Remote work- 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
- ...Pre-Authorization Nurse to review prior authorization requests... ...decision-making abilities. Remote position from LA with a... ...Thurs), 8-hour shifts. Active RN license in Louisiana and 2+... ...RN experience are required; health plan or utilization management background is a plus...Remote workShift work
- ...integrating, and monitoring the utilization of behavioral health (BH) or physical health (PH... ...the Medical Director for review. Refer to and work closely... ...degree and active NYS RN license required. Bachelors... ...There may be opportunity for remote work within all jobs posted...Remote workContract workWork at office
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workHourly payPart time- 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 jobWork from home
- ...Providing timely and evidence-based utilization review services, the full-time Utilization Review RN will work remotely to manage complex medical conditions, treatment planning, and recovery for injured employees while advocating for effective medical treatment. Key responsibilities...Remote workFull timeWork experience placement
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...Remote workFull time
- ...Job Description Job Description The utilization review and management (UM) component program ensures that external healthcare services provided... ...– 5 pm with one hour for lunch This is an in-office, no remote work capability position Travel ~ Some travel may be...Remote workWork at office
- ...Behavioral Health Utilization Reviewer The Behavioral Health Utilization Reviewer is responsible for conducting clinical reviews of behavioral health... ...degree in social work, counseling, or behavioral health RN license in Louisiana can replace the Bachelor's Degree -...Remote workWork at office
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