Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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
Vacancy posted 3 hours ago
Similar jobs that could be interesting for youBased on the Remote Behavioral Health Utilization Reviewer in United States vacancy
  •  ...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 work
    Work at office

    Louisiana Blue

    United States
    1 day ago
  •  ...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 work
    Weekday work

    IntelliResume

    Louisiana, MO
    1 day ago
  •  ...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

    Comagine Health

    Oregon, WI
    5 days ago
  • $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 work
    Hourly pay
    Full time
    Part time
    Work from home
    Home office

    Oscar

    New York, NY
    17 days ago
  •  ...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 work
    Contract work
    Work at office

    Excellus BCBS

    Utica, NY
    3 days ago
  •  ...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 work
    Full time
    Work from home

    ExamWorks

    United States
    2 days ago
  •  ...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 work
    Full time
    Casual work
    Monday to Friday

    ExamWorks UM Strategies

    United States
    2 days ago
  •  ...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

    Dane Street

    United States
    4 days ago
  •  ...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 work
    Full time

    Oak Street Health

    Richmond, VA
    2 days ago
  • $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 work
    Weekly pay
    Full time
    Work at office
    Work from home
    Home office
    Monday to Friday
    Flexible hours

    Humana

    Louisiana, MO
    5 days ago
  •  ...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

    Centene Management Company LLC

    United States
    5 days ago
  •  ...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

    Sentara Health

    Richmond, VA
    5 days ago
  •  ...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 Corporation

    Louisiana, MO
    5 days ago
  •  ...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 work
    Weekend work

    IntelliResume

    Louisiana, MO
    1 day ago
  • 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 job
    Flexible hours

    IntelliResume

    Raleigh, NC
    3 days ago
  • $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

    NurseRemotely

    United States
    5 days ago
  • $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 work
    Hourly pay
    Contract work
    Monday to Friday
    Flexible hours
    Weekend work

    AmeriHealth Caritas

    Washington DC
    5 days ago
  •  ...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 work
    Monday to Friday
    Flexible hours
    Weekend work

    AmeriHealth Caritas

    Newtown Square, PA
    2 days ago
  • $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 work
    Full time
    Work at office
    Relocation package
    Flexible hours

    RemoteWorker US

    Brooklyn, NY
    1 day ago
  • $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 work
    Hourly pay
    Full time
    Part time
    Work at office
    Flexible hours

    Centene Corporation

    Louisiana, MO
    1 day ago
  •  ...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 work
    Shift work
    Weekend work

    Centene Corporation

    United States
    2 days ago
  • 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 job
    Monday to Friday

    Centene Corporation

    Florida, NY
    3 days ago
  •  ...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 job
    Flexible hours

    Centene Corporation

    California, MO
    5 days ago
  •  ...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 work
    Immediate start
    Work from home

    ABA Dynamic

    New York, NY
    27 days ago
  • $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 work
    Hourly pay
    Work at office

    S R International, Inc.

    Phoenix, AZ
    6 days ago
  •  ...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 work
    For contractors

    ezURs Inc

    United States
    4 days ago
  •  ...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 work
    Contract work
    For subcontractor
    Interim role
    Shift work

    Pacer Group

    Phoenix, AZ
    3 days ago
  •  ...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 work
    Work from home

    GRAND VALLEY BEHAVIOR SERVICES AND

    Grand Junction, CO
    4 days ago
  •  ...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 work
    Work from home

    Constellation Health Service

    United States
    3 days ago
  • $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 work
    Hourly pay
    Full time
    Work at office
    Local area

    ChenMed

    Miami, FL
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Behavioral Health Utilization Reviewer. Be the first to apply!