Remote Behavioral Health Utilization Reviewer
Comagine Health
- Remote job
Comagine Health is seeking a Behavioral Health Reviewer based in Oregon. Responsibilities include reviewing clinical documentation for medical necessity, conducting assessments, and managing referrals in a remote capacity. Applicants should possess a relevant master's degree, active clinical licensure, and have at least three years of direct patient care experience. The position also requires personal transportation and ability to travel. Comagine offers a supportive remote work environment with comprehensive benefits. #J-18808-Ljbffr Comagine Health
$65k - $88.6k
Humana is seeking a Behavioral Health Utilization Management professional to support clinical reviews for prior authorizations. The role requires IL-licensed clinicians with... ...health and utilization review processes. Remote work with occasional travel to Humana offices...Remote jobWeekly pay- ...Umpqua Health is seeking an Utilization Review Clinician to perform clinical reviews for mental health and substance use services. This remote role may require on-site travel to Roseburg, OR as needed and offers a full-time exempt schedule. The URC collaborates with care...Remote workFull time
- ...coordinating, integrating, and monitoring the utilization of behavioral health (BH) or physical health (PH) services... ...cases to the Medical Director for review. Refer to and work closely with Case... ...note: There may be opportunity for remote work within all jobs posted by the...Remote workContract workWork at office
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The... ...Medicine, preferably with experience in health insurance. This position offers a... ...opportunities to leverage clinical expertise in utilization management. #J-18808-Ljbffr...Remote work
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to ensure accurate coverage determinations for inpatient and outpatient services.... ...license to practice in the US. This position offers remote work options and competitive compensation...Remote workFull time
$130 - $145 per hour
...’re Oscar. We’re hiring a part-time Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology... ...Management. Work Location This is a remote position, open to candidates who reside in the...Remote workHourly payFull timePart timeLocal areaWork from homeHome officeWeekend work- ...organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical... .... A comprehensive benefits package including health plans and 401(k) is offered, promoting equality...Remote work
- ...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...Remote workFull time
- ...team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern... ...Ready to join our quest for better? *Shifts are weekdays. Utilization Reviewer Responsibilities Responsible for utilization review calls within...For contractorsReliefWork at officeLocal areaRelocation packageShift workWeekday work
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote jobFor contractorsMonday to FridayFlexible hours
- ChenMed is seeking a Physician Reviewer to lead utilization management reviews and advise fellow physicians. The role includes coordinating care with health plans and local teams, participating in QA and delegated UM processes, and supporting territory-based case development...Remote jobLocal area
- ...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...Remote work
- Centene is seeking an Utilization Review Clinician for Behavioral Health. The role focuses on clinical reviews and evaluating care related to mental health and... ...a strong impact on patient care. The position offers remote work options with a daytime schedule and full-time...Remote jobFull time
$60.52k - $129.62k
...Care Plan Reviewer (Clinical Case Manager BH) We're building a world of health around every individual — shaping a more connected... ...(Clinical Case Manager BH) utilizes advanced clinical judgment and... ...supports appropriate member behavioral healthcare through review of...Remote workHourly payFull timeTemporary work$86k - $117.3k
...For roles that are 100% remote or hybrid, you must have access... ...the nation's leaders in health care solutions, we offer... ...specialty pharmacy services, behavioral health services, and other... ...of a supervisor, the Utilization Management Reviewer evaluates medical necessity...Remote workHourly payContract workMonday to FridayFlexible hoursWeekend work- ...Role Overview Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient... ...independently applies medical and behavioral health guidelines to authorize services,... ...Flexible work solutions include remote options, hybrid work schedules, competitive...Remote workMonday to FridayFlexible hoursWeekend work
- Humana Inc. is seeking a Utilization Management Behavioral Health Professional to perform clinical reviews, apply evidence-based criteria, and document determinations for behavioral health services. This remote role supports providers and internal teams in ensuring medically...Remote job
$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$87.7k - $157.8k
...professional on our Medical Management/Health Services team. Centene is a... ...Centene is hiring a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA) with a focus on... ...practitioners on best‑practice models and utilization management processes....Remote workWork at officeFlexible hours- Humana Inc. is seeking a Utilization Management Behavioral Health Professional for remote roles across several states. You will perform clinical reviews of behavioral health prior authorizations, coordinate with medical directors, and document all decisions in the system...Remote job
$86k - $154.7k
...for the Psychologist Reviewer role at RemoteWorker... ...our Medical Management/Health Services team. Centene... ...Centene is hiring a Remote Psychologist – Join Our... ...for improving access to behavioral health care? Centene... ...well as participating in Utilization Management clinical...Remote workFull timeWork at officeRelocation packageFlexible hours$42.18 - $51.56 per hour
## Physical Therapy Utilization Management ReviewerApplylocations: Hinghamtime type: Full... ...Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness... ...team includes clinicians, medical and behavioral health care managers, dietitians, pharmacists...Work at officeFlexible hoursShift work- ...Program Company Overview Mental Health Resource Center is a not-for-profit... ...a wide range of mental health and behavioral health care services to the... ...Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical...Full timeMonday to FridayFlexible hours
- ...corresponding level of care utilizing evidence-based criteria. Responsibilities... ..., and Case Management. Reviews the appropriateness of... ...Collaborates with family, health care team, payors, and... ...Partners-in-Caring process and the behavioral expectations in all interactions...Contract workWork experience placementFlexible hours
$27.02 - $48.55 per hour
...on our Medical Management/Health Services team. Centene is a... ...Oklahoma Complete Health â?? Behavioral Health Utilization Management Training... ...Purpose: Performs a clinical review and assesses care related to... ...flexible approach to work with remote, hybrid, field or office...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...Description Physician Peer Reviewer – Multiple Specialties in Texas... ...Organization (IRO) with Health Utilization Management (HUM) accreditation... ...Medicine, Developmental-Behavioral Pediatrics, Pediatric Emergency... ...reviews Job Type Contract Work Location Remote...Remote workContract workWork experience placementWork at office
- ...diversified national organization is seeking a Licensed Clinical Behavioral Health Professional or RN to assess care related to mental health... ...evaluating treatment needs, performing authorization reviews, and improving service quality. Ideal candidates should have...Remote workFlexible hours
$29.29 - $50.38 per hour
...Treatment Plans. Will complete thorough review of each document, provide clinical... ...IATP standards. LPHA reviewer provides behavioral health assessment, intervention, and consultation... ...screening and/or assessment tools and utilization of results in treatment planning....Full timeLocal areaImmediate startRelocationRelocation packageShift work$91.7k - $163.7k
...our team will directly improve health outcomes by connecting people... ...Public Sector or Applied Behavior Analysis which involves applying... ...determinations.Services reviewed may include, but are not limited... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaWork from homeMonday to Friday- ...Behavioral Health Case Manager Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical necessity... ...position is full-time, fully remote (work from home) and requires some...Remote workFull timeWork from homeShift workWeekend workAfternoon shift
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