Remote Behavioral Health Utilization Reviewer
Comagine Health
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, active clinical licensure, and have at least three years of direct patient care experience. The position also requires personal transportation and ability to travel. Comagine offers a supportive remote work environment with comprehensive benefits. #J-18808-Ljbffr
- ...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
- 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
- ...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
- Comagine Health is seeking a remote clinical reviewer to evaluate medical necessity for behavioral health services across a national footprint. The role requires applying evidence-based criteria, managing high-volume reviews, and documenting outcomes within the EMR. You...Remote jobFull time
$80.75k - $98.68k
...colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care... ...level of care to promote optimal health. This position is self-directed and... ...professionals, including medical and behavioral health care managers, dieticians, pharmacist...SuggestedFull timeShift 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
- ...ChenMed is looking for a Licensed Physician Reviewer – Ortho for a remote role based in Miami, FL. This position involves conducting Utilization Management reviews and advising other physician reviewers while participating in quality improvement efforts. The ideal...Remote 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
- 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
$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- 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
$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$174.07k - $374.92k
...Full-Time Utilization Management Physician Reviewer We're building a world of health around every individual — shaping a more connected, convenient and compassionate... ...time. Company: Oak Street Health Location: Remote/ Treehouse Role Description: This full-...Remote workHourly payFull time- ...Orthopedic Spine Surgeon Reviewer Dane Street, a nationally recognized Independent Review Organization (IRO), is... ...Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with...Remote workPrice workExtra incomeFor contractorsFlexible hours
- ...physician with strong clinical and UM background to cover delegated utilization management across multiple territories. The role requires... ..., and 2+ years in hospital medicine, with utilization review experience preferred. You will coordinate with PCP/SNF meetings...Remote job
- 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 ensure...Remote jobFull time
- ChenMed LLC is seeking a Physician Reviewer to lead delegated utilization management (UM) reviews across multiple markets. You will establish daily case counts, attend essential calls with health plans, advise other reviewers, and participate in ongoing process and quality...Remote job
- ...organization is seeking experienced Physician Reviewers to join their Medicare Utilization Management team in a remote position. Responsibilities include reviewing clinical... .... A comprehensive benefits package including health plans and 401(k) is offered, promoting equality...Remote job
- A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday - Friday work week. Responsibilities include reviewing medical records,...Remote jobFor contractorsMonday to FridayFlexible hours
- 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 jobFull timeCasual workMonday to Friday
- ...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
- 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
- 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
$27.02 - $48.55 per hour
...Purpose Performs a clinical review and assesses care related to mental health and substance abuse.... ...flexibility to work remotely from their home anywhere... ...Performs concurrent review of behavioral health (BH) inpatient... ...and appropriate utilization of services Provides education...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- WellSense Health Plan is seeking a Behavioral Health Utilization Manager to ensure appropriate, effective delivery of mental health and substance use services.... ...communication, with a focus on quality and compliance. Remote work is supported. #J-18808-Ljbffr WellSense Health...Remote job
- ATHENA Consulting is seeking a part-time Utilization Manager Clinician for a remote role based in Hanover, MD. The position reviews behavioral health services and coordinates case management to optimize member outcomes, requiring MD licensure and a health professional...Remote jobPart timeFlexible hoursWeekday work
$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- Sentara Health Plan PG in the United States seeks a Behavior Health Utilization Management Care Coordinator to work with medically and behaviorally complex members. The... ...both in-person face-to-face assessments and remote telephonic assessments for SMI, SED (ages 2+),...Remote 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 - $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
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