Remote Behavioral Health Utilization Reviewer
Comagine Health
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 determinations in an electronic medical record system while supporting care coordination across children, youth, and adults.
This remote, Oregon-based role requires active licensure (e.g., LCSW, LPC, LCPC), 3 years of direct clinical experience, and willingness to travel in the Eugene
#J-18808-Ljbffr- ...Behavioral Health Utilization Reviewer The Behavioral Health Utilization Reviewer is responsible for conducting clinical reviews of behavioral health service requests, claims, and appeals to confirm medical necessity and appropriateness of care. The reviewer applies...Remote workWork at office
- ...AmeriHealth Caritas is seeking a BHUM Reviewer to conduct medical necessity... ...clinical knowledge in mental health and substance use to support appropriate... ...work credentials, experience in utilization management, and the ability to work remotely within the US; remote options...Remote workWeekday work
- ...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...Remote work
$130 - $145 per hour
...Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built... ...Management. Work Location: This position is fully remote and open to candidates residing in the U. S. , excluding...Remote workHourly payFull timePart timeWork from homeHome office- ...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
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- ...A leading independent review organization is seeking a Utilization Management Physician Reviewer for a full-time remote role. Candidates must possess an active Nebraska medical license and have a minimum of 5 years clinical practice experience. Responsibilities include...Remote workFull timeCasual workMonday to Friday
- ...Dane Street, a certified "Great Place to Work" company is seeking a Physician to provide utilization review services for the Group Health Department. This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical...Remote work
- ...Oak Street Health is seeking a Full-Time Utilization Management Physician Reviewer to provide accurate coverage determinations for inpatient and outpatient services, applying UM criteria, clinical judgment, and internal policies. You will coordinate with care teams to...Remote workFull time
$65k - $88.6k
# **Become a part of our caring community**The Utilization Management Behavioral Health Professional uses behavioral health knowledge and skills to support... ...member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for...Remote workWeekly payFull timeWork at officeWork from homeHome officeMonday to FridayFlexible hours- ...Centene Management Company LLC is seeking a clinical reviewer for behavioral health with an active North Carolina license. The role focuses on... ...across the care continuum. The ideal candidate has BH utilization review experience, strong communication skills, and the...Remote work
- ...Sentara Health in Richmond, VA is hiring a Behavior Health Utilization Management Care Coordinator to support members who are medically and behaviorally complex. The role requires both in-person assessments and remote telephonic assessments for serious mental illness,...Remote work
- ...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
- ...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 a remote Utilization Review Clinician - Behavioral Health based in North Carolina. You will evaluate treatment plans, perform prior authorizations, and conduct concurrent reviews for mental health and substance use services. Ideal candidates hold a master...Remote jobFlexible hours
$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$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
$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$27.02 - $48.55 per hour
...Purpose Performs a clinical review and assesses care related to mental health and substance abuse.... ...concurrent review of behavioral health (BH) inpatient to... ...and appropriate utilization of services Provides education... ...approach to work with remote, hybrid, field or office...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...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...Remote workShift workWeekend work
- Centene Corporation is seeking a remote Behavioral Health Reviewer to assess mental health and substance abuse care, perform prior authorizations, and guide discharge planning within a clinical setting. Candidates should have 5+ years in behavioral health and relevant licensure...Remote jobMonday to Friday
- ...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 jobFlexible hours
- ...Join the ABA Dynamic team as a Home-Based Behavior Technician! We believe that the most... ...Environment Adaptation: Identify and utilize natural opportunities within the home (playroom... ...precisely as written by the BCBA. Remote Reporting: Accurately log session notes...Remote workImmediate startWork from home
$27 per hour
...Grant Proposal Reviewer Rural & Tribal Health Programs Entry-level reviewer responsible for reading... ...program staff Preferred Skills Behavioral Health Knowledge familiarity with BH... ...community health environments This is a remote position. Compensation: $27.00...Remote workHourly payWork at office- ...ezURs is seeking board-certified Pain Management Physicians for fully remote Physician Consultant positions. As a URAC accredited Independent Review Organization, our physicians perform utilization reviews, disability, and peer reviews across multiple lines of business...Remote workFor contractors
- ...Claims Reviewer Location: Phoenix AZ 85053 (REMOTE) Duration: 6+ Months Pay Range: $28.00/hr on W2 Shift: Mon Fri 8.00 AM 5 PM PST Job... ...retrospective review of medical/surgical claims and behavioral health claims for inpatient and outpatient services, as it...Remote workContract workFor subcontractorInterim roleShift work
- ...Competitive salary Health insurance Opportunity... ...not. At Grand Valley Behavior (GVBSC), a BCBA owned... ...telehealth or paperwork review. While appropriate treatment... ...and celebrated Utilize our data collection system... ...collaboration over remote oversight Enjoys mentoring...Remote workWork from home
- ...Job Description Summary The Behavioral Technician will provide clinical skills instruction... ...client care in 1:1 and group settings utilizing a combination of intensive teaching and... ...to all employees of Constellation Health Services: All employees will: Exercise...Remote workWork from home
$204.76k - $292.52k
...join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization... ...and attending daily calls with health plan teams and our local teams... ...Contingent Worker please see job aid HERE to apply #LI-Remote...Remote workHourly payFull timeWork at officeLocal area
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