Remote Behavioral Health Utilization Review Clinician
Centene Management Company LLC
- Remote job
Centene Management Company LLC is seeking a remote Utilization Review Clinician – Behavioral Health to support our Behavioral Health Medicare Plan. You will perform medical necessity reviews and authorization determinations to help ensure members receive appropriate, high-quality behavioral health services. The role requires licensure such as LCSW/LMHC/LPC/LMFT/LMHP or RN, a Master’s degree in behavioral health, and 2–4 years of related experience, with a Monday–Friday EST schedule and #J-18808-Ljbffr Centene Management Company LLC
- ...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
$27.02 - $48.55 per hour
...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- ...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 is seeking a Behavioral Health Reviewer to assess and authorize mental health and substance abuse care across the care continuum... ...and relevant licensure; master’s degree for behavioral health clinicians is preferred. #J-18808-Ljbffr Centene CorporationRemote job
- ...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
- Centene Corporation is seeking a clinical review professional to support the Kentucky market in a fully remote capacity. The role involves inpatient behavioral health precertification reviews, with first, second, and third shift options and training on a Monday-Friday...Remote jobMonday to FridayAfternoon shift
- Centene Corporation is seeking a clinical reviewer to assess mental health and substance use care, including prior authorization and concurrent BH... ...appropriate and coordinates with providers and families. This remote position supports working from home anywhere in the...Remote jobWork from homeWeekday work
- Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and guideline alignment... ...a 90-day in-office training, the position offers remote work from home options. #J-18808-Ljbffr Nationwide...Remote jobWork at officeWork from home
- Point32Health in Massachusetts seeks a Behavioral Health Utilization Management Clinician to conduct benefit coverage reviews and clinical determinations under supervision within... ...while maintaining regulatory compliance. Remote work as required with a fast-paced environment...Remote job
$80.47k - $94.55k
UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as... ...TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than a... ...primary care, specialty care, behavioral health services, and care coordination...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hours- 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
- 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
- Centene Corporation is seeking a clinician to perform clinical reviews and assess care for mental health and substance use services. The role supports level of care... ...collaborating with BH teams to ensure appropriate utilization and quality outcomes. The ideal candidate will...Remote job
$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 around... ...Management. Work Location: This position is fully remote and open to candidates residing in the U.S.,...Remote workHourly payPart timeWork from homeHome office- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days... ...help patients achieve optimal health, access to care, and appropriate... ...years of acute hospital or behavioral health patient care... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
$57.51k
...Utilization Review Therapist: Billing and Patient Accts- License Eligible Masters Required- Remote! A career can mean different things at different workplaces. Apply now to... ...Qualifications: Education: Master's degree in behavioral health field Experience: Experience in...Remote jobFull timeSeasonal workWork at officeLocal areaMonday to Friday- 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
- 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...Remote job
- 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 jobFull time
- Centene is seeking a Behavioral Health Nurse/Clinician to evaluate mental health and substance use treatment, conduct prior and concurrent reviews, and educate providers and families. This remote role serves the Kentucky market with a full-time schedule across multiple...Remote jobFull timeShift work
- ...This is a great opportunity for a local remote position. Schedule PRN (As needed)... ...support all units/staff (commercial, behavioral health, inpatient, etc). Requirements: 2 years... ...hospitalized patients. 2 years of utilization review (UR) experience reviewing hospital admissions...Remote workReliefLocal areaMonday to FridayFlexible hoursShift work
- 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 jobFull timeWork from home
- Nationwide Children’s Hospital is seeking a Behavioral Health Utilization Review Specialist to review cases, determine medical necessity, and ensure compliance with guidelines. The role conducts pre-certifications, pre-authorizations, and retrospective reviews, collaborating...Remote jobWork at officeWork from home
- ...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
- ...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
$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- Centene in the United States seeks a Behavioral Health Review clinician to assess mental health and substance use care, determine level of care, and authorize services. The role requires a nursing or master’s qualified clinician, U.S. licensure (RN, LCSW, LMHC, LPC, LMFT...Afternoon shift
- ...Job Title Behavioral Health Utilization Management Clinician Location Florida (Remote) Job Description This position requires a clinician with a preference... ...providing inpatient medical necessity/utilization review and other utilization management activities...Remote workWork at office
- ...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
- ...R1 RCM is seeking an experienced Utilization Review Author (RN) for our Physician Advisory Team. The role involves first-level admission and continued stay reviews using InterQual/MCG criteria and requires hospital-based UR or Case Management experience. The position...Remote workFlexible hours
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