Remote Utilization Review Clinician, Behavioral Health
Umpqua-Health
- Remote job
Umpqua Health in Oregon is seeking a Utilization Review Clinician to perform clinical reviews and assess care related to mental health and substance use disorders. This full-time, exempt role requires evaluating medical necessity, level of care, and coverage decisions in collaboration with care teams. You will work with behavioral health providers, participate in appeals, and support transitions of care, with occasional on-site travel to Roseburg. #J-18808-Ljbffr Umpqua-Health
$56.2k - $100.98k
...Performs a clinical review and assesses care... ...to mental health and substance abuse... ...flexibility to work remotely from their home... ...concurrent review of behavioral health (BH)... ...and appropriate utilization of services Provides... ...health clinicians required. Clinical...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- ...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
$56.2k - $100.98k
...Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA)... ...Details: This is a remote position, but applicants... ...and appropriate utilization of services Interacts... ...for behavioral health clinicians required....Remote workHourly payFull timePart timeWork at officeMonday to FridayFlexible hours- CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role available nationwide. You will review preauthorization requests for behavioral health services, coordinate decisions, and support crisis assessments with clinical judgment....Remote job
- Sentara Health Plans is seeking an Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for a remote role in Virginia and North Carolina. You will review clinical information to confirm medical necessity and authorize services as needed. Required...Remote job
$54.1k - $142.58k
...Behavioral Health Utilization Management Clinician We're building a world of health around every individual shaping... ...professional looking for a rewarding remote role that combines clinical... ...included What You'll Do: Review preauthorization requests for behavioral...Remote workHourly payFull timeShift workNight shiftWeekend work$80.47k - $94.55k
...UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR 9... ...Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than... ...through primary care, specialty care, behavioral health services, and care...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hours- ...Centene is seeking a Utilization Review Clinician to assess mental health and substance use care across the continuum. Two schedules are available, with 1... ...times: 8:00 or 9:00 AM ET. Requires RN or Master’s in Behavioral Health, 2–4 years of related experience, and...Remote workShift work
- FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations... ...candidate should have 2-3 years of UR experience in behavioral health, with strong ASAM criteria knowledge and...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- Monte Nido is seeking a Utilization Review Clinician to join our team with on-site options in Miami or remote work available. The role centers on conducting utilization reviews, peer reviews, and pre-certifications while coordinating with the on-site clinical team, admissions...Remote job
$24 - $26 per hour
Remote Authorization Specialist Remote | Full-Time | 9a-5p Monday... ...-certifications, concurrent reviews, verifying benefits,... ...Backgrounds that translate well Utilization Review · Insurance Authorization/Precertification · Behavioral Health Case Management What You'll...Remote jobFull timeMonday to Friday- ...Utilization Review NurseThis position has a remote option for those living close and will be able to come into the hospital... ...with other members of the health care team to ensure the above according... ...'s member's health care for behavioral health care management.Follow CHRISTUS...Remote workFull time
- ...with low deductible/low cost health planGenerous vacation and... ...EmployerOffice Location: Remote option in NC; Available... ...services and need for Peer Review when the MHSU Utilization Management Reviewer cannot... ...major diagnostic categories; behavioral health principles,...Remote workContract workWork at officeShift work
- ...Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing... ...in utilization review, case management, or behavioral health and enjoy collaborating with interdisciplinary...Remote jobWork at office
- ...This is a great opportunity for a local remote position. Schedule PRN (As... ...support all units/staff (commercial, behavioral health, inpatient, etc). Requirements:... ...hospitalized patients. ~2 years of utilization review (UR) experience reviewing hospital admissions...Remote workReliefLocal areaMonday to FridayFlexible hoursShift work
- ...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
- 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
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...an accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
- ...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 healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The ideal candidate will have...Remote workContract work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels... ...Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable). InterQual...Remote work
- ...Johns Hopkins Health Plans is seeking a Utilization Review Registered Nurse to apply clinical, managed care and utilization review expertise to improve member outcomes. This remote role supports the organization with standard hours; you will monitor care relevance, evaluate...Remote work
$85.99k - $105.34k
...A community-focused healthcare organization in Oregon is seeking a Utilization Review Nurse for a full-time remote position. The role involves evaluating clinical service requests, conducting prior authorization reviews, and collaborating with interdisciplinary teams....Remote workFull time- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...license and have experience in utilization review or home health. This contract role offers a chance to manage healthcare quality...Remote workContract work
$219k - $286.9k
...Hi, we're Oscar. We're hiring a 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 workFull timeLocal areaWork from homeHome officeWeekend work- ...Registered Nurse - Utilization Review About Company Bestica: We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
$93k - $100k
...CoventBridge Integrity Systems seeks a Medical Review Supervisor (MCP) to lead the MR... ...compliance, reporting to the MR Project Manager. Remote from home OFFICE when not local in Grove... ...experience, and 4+ years in medical/utilization review or fraud investigation. Salary...Remote workLocal areaHome office$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient, outpatient, and... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home...Remote jobWork from home
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