RN Utilization Review Specialist — Behavioral Health
Molina Healthcare of Illinois
Molina Healthcare is seeking a Registered Nurse with an OH or compact license to join the Care Review Clinician team. You will provide prior authorization for behavioral health services for the Ohio Medicaid population and support member care across the continuum. Key responsibilities include reviewing requests for clinical necessity, collaborating with medical directors, and ensuring compliance with state and federal guidelines. Monday–Friday, with rotating weekends and holidays. #J-18808-Ljbffr Molina Healthcare
- UofL Health is seeking an RN for Utilization Review in Louisville, KY. The role supports the Utilization Management process, reviews medical necessity, and coordinates care across interdisciplinary teams to ensure appropriate utilization and patient outcomes. The ideal...Suggested
- ...’ll contribute How you’ll contribute Utilization Review Specialist facilitates clinical reviews on all patient... ...plans, plus flexible-spending and health- savings accounts Competitive paid... ...with acute care, rehabilitation, and behavioral health facilities from coast to coast...SuggestedTemporary workFlexible hours
- Recovery Council, Inc. seeks an UM Specialist to support prior authorization, medical billing, utilization review (UR) and patient access for behavioral health and addiction services. Strong ASAM criteria knowledge and DSM-5/ICD-10 familiarity are required to validate...Suggested
$39.4 - $53 per hour
...revenue cycle management solutions for health systems, including hospitals and... ...Career Advancement This position pays: RN pay scale $39.40 - $53/hr based on experience... ...other weekend We are seeking Virtual Utilization Review Specialists to join our team. Resource Utilization...SuggestedTemporary workWork at officeLocal areaRemote workMonday to FridayWeekend work- ## RN Utilization ReviewApplylocations: Louisville, Kentuckytime type: Full... ...Summary:**About UofL Health: UofL Health is a fully integrated... ...and Purpose** The Utilization Review RN performs activities which... ...Three years’ experience with Behavior Health experience (required for...SuggestedWork at officeShift work
$23.76 - $51.49 per hour
Behavioral Health Experience Required. Seeking a Registered Nurse with a OH... ...compact license. The Care Review Clinician will provide prior... ...or previous experience with Utilization Reviews. SCHEDULE Monday thru... .... Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeMonday to Friday- CorVel Corporation seeks an Itemization Review Nurse to analyze charges on UBIB submissions for accuracy. This remote role requires RN licensure in the applicable state and 5 years of OR/ICU/ER experience. Responsibilities include data collection, documentation in the...Remote job
- MarinHealth is seeking a Utilization Review Nurse II to perform admission, concurrent and retrospective reviews for designated health plans in a 40-hour week on days at Greenbrae, CA. The role requires a BSN preferred, 3+ years of acute care experience, and experience...
- ## Utilization Review RN II, Care Coordination, Full-Time, DaysApplylocations: Greenbrae, CAtime type: Full timeposted on: Posted 2 Days Agojob... ...class physician and clinical team, an affiliation with UCSF Health, an ever-expanding network of clinics, and a new state-of-...Full timeWork at officeLocal areaShift work
- Capital Health seeks an experienced Utilization Review Supervisor for 40 hours/week in Trenton, NJ. The role oversees UR staff, ensures compliant reviews, and... ...from an accredited school of nursing and an active NJ RN license, with several years in case management or UR. The...Full time
- Johns Hopkins Health Plans (JHHP) is seeking a Utilization Review Registered Nurse to assess care appropriateness, authorize services, and coordinate discharge planning for plan members. This remote role prioritizes candidates in MD, DC, VA, PA, DE, and FL with strong clinical...Remote job
- ## Associate Behavioral Health Specialist (Psychosis, 3pm - 11pm)Applylocations: Nashville, TNposted on:... ...daily living as directed by the assigned RN. • Provides input to the patient’s... ...technology quickly; understands when to utilize the appropriate tools and procedures to...Work experience placementImmediate start
- Memorial Physician Practices is seeking a full-time Assessment Specialist, RN in Kentucky. This vital role focuses on providing exceptional care to patients with mental health needs. Responsibilities include performing assessments, providing direct care, and coordinating...Full timeNight shift
- Assessment Specialist, RN Full-time, Night Shift Your experience matters... ...is part of Lifepoint Health, a diversified healthcare delivery... .... Screens for medical and behavioral emergency conditions. Performs... ...communication with external review organizations or comparable...Full timeTemporary workPart timeReliefFlexible hoursShift workNight shift
- Assessment Specialist (RN, LSW or LPC) Full-time, Night Shift $5,000 Sign... ...is part of Lifepoint Health, a diversified healthcare delivery... .... Screens for medical and behavioral emergency conditions. Performs... ...communication with external review organizations or comparable...Full timeTemporary workPart timeReliefRelocation packageFlexible hoursShift workNight shift
- Behavioral Health Specialist- Fairfield County Job Category: Paraprofessional Clinical Requisition Number: BEHAV008568 Posted: April 23, 2026... ...including basic, mental health and substance use needs. Review Diagnostic Evaluation and additional assessments, to aid in...Full timeContract workInternshipWork at officeImmediate startWork from homeFlexible hoursWeekend workAfternoon shift
- Behavioral Health Specialist MRSS Fairfield County Full Time 8am-8pm You have a place atOhioGuidestone, the state's leader in behavioral health!OhioGuidestoneis... ...federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor....Full timeTemporary workInternshipWork at officeWork from homeFlexible hours
- Behavioral Health Care Mgmt Clinician, Senior (RN Compact state license only) AZ, United States and 10 more Job Description... ..., and criteria. Interacts with Utilization department and Physician Advisors... ...subject to change with periodic reviews. Physical Requirements: Office...Full timePart timeWork at officeLocal areaWork from homeHome office2 days per week
- # Behavioral Health RN27 N Vann St, Pryor, OK 74361June 16, 2026Full TimePart TimeApply Now**Deadline... ...-day SNVs and OASIS within 48 hours* Utilize appropriate behavioral health and... ..., including responding to QA and coder reviews and performing clinical record audits*...
- Personify Health is seeking a qualified RN to perform medical-necessity reviews, ensuring appropriate care levels and strict adherence to policy language and regulatory requirements. You will evaluate documentation, escalate non-certifications, and coordinate with Medical...
$85.28k - $132.18k
## RN - Pediatric Developmental & Behavioral OfficeApplylocations: 391 Myrtle Avenue Albany,... ...results in EHR • Performs review and triage of incoming... ...education • Facilitates the utilization of resources to meet... ...their visit and overall health and wellness**Minimum Qualifications...Work at officeShift work$30 - $38 per hour
Because health is personal. That's why Personify Health created the first and only personalized... ...into life-changing decisions, one review at a time? Why This Role Matters Every determination... ...& Experience: Current, unrestricted RN license in the United States or a U.S....Hourly payImmediate startMonday to FridayFlexible hours$24 - $26 per hour
...towards sustainable mental wellness? As a Behavioral Health Associate , you will work... ...Health Associate role. Responsibilities Utilize de-escalation techniques and crisis management... ...with their daily needs and activities. Review and apply treatment team strategies daily...Hourly payTemporary workShift workNight shift$25 - $31 per hour
Because health is personal. That's why Personify Health created the first and only personalized... ...on your desk is a moment where your review decides what happens next for a real... ...accuracy and pace are what keep the entire utilization review process trustworthy. Schedule:...Hourly payMonday to Friday$55k
...The Harm Reduction Specialist provides engagement and... ...and alcohol use, sexual health and self-harm, using a... ...individuals engaging in risky behaviors. In addition, the Harm... ..., including reviewing service plans with program... ...andsafety hazards, utilizing individualized strategies...Local areaFlexible hoursWeekend workAfternoon shift$25.48 - $37.02 per hour
...Senior Housing & Community Support Specialist Department Behavioral Health/Population Health Research Schedule... ...for patient to achieve those goals utilizing skills such as motivational interviewing... ...frames. Presents patients at case review meetings succinctly and logically....Work experience placementWork at officeLocal areaRemote workFlexible hours- ## RN - Lawrence Neurology SpecialistsApplylocations: Lawrence... ...joy, purpose and lifelong health - it shows. At LMH Health, we... ...outcomes of care processes by:* Utilizing information, resources and... ...clinic/area of specialty:* Breast Specialists: Commission on Cancer...Flexible hours
$145k - $160k
...Nurse Manager Behavioral Health $145,000 to $160,000 Hospital Leadership Opportunity | Brooklyn, New York... ...budgeting, supply management, and staffing plans Review operational data and prepare reports as needed Utilize benchmarks and quality tools to improve...Monday to Friday- ...Cleveland Clinic Akron General is seeking an RN Specialist in Electrophysiology to provide... ...experience are preferred. At Cleveland Clinic Health System, we believe in a better future... ...of Health Care Administration: Please review the Equal Employment Opportunity poster...Permanent employmentMonday to FridayShift work
- Highland Springs is seeking an Assessment Specialist (RN, LSW, or LPC) for Full-time Night Shift. A $5,000 sign-on bonus is offered.... ...supports assessment and treatment planning for patients in a behavioral health setting. As part of Lifepoint Health, you will collaborate...Full timeRelocation packageNight shift
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