Remote Utilization Review Specialist - Behavioral Health
Hansei Solutions
Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking, and advocacy.
You will collaborate with clinical staff to optimize authorization decisions, manage caseloads, and ensure accurate documentation while staying compliant with HIPAA regulations.
#J-18808-Ljbffr- ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining and maintaining... ...ideal candidate has prior utilization review or behavioral health experience, strong knowledge of payer...Remote workPart timeWeekend work
- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete prior... ...necessity criteria while working remotely. Key responsibilities Verify insurance...Remote workFull time
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant... ...optimization, compliance, and high-quality patient care across behavioral health services. #J-18808-LjbffrRemote work
- ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...Remote work
$24 - $26 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...Remote workFull timeMonday to Friday$90.9k - $129.9k
...Apply your expertise to adjudicate Behavioral Health prior authorizations based on medical... ...for this role, rather you will provide utilization review and quality assurance. Your role... ...should expect in this role ~100% Remote home office. ~ Full-time position...Remote workFull timeWork experience placementHome officeFlexible hours- ...monitoring the Mental Health Plan and Drug-Medi-... ...-ODS), including review of medical records to ensure proper utilization of treatment... ...clients receiving behavioral health treatment. UR Specialists also interpret, advise... ...option for hybrid remote work may be available...Remote workContract workLocal areaTrial periodFlexible hours
- Principles Recovery Center is seeking a remote Utilization Review Specialist to manage insurance authorizations for adolescent and adult behavioral health, PHP, and IOP programs. The role requires 2+ years of UR experience and fluency with ASAM, LOCUS, and CALOCUS criteria...Remote job
- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
- ...Kent County Cmh Authority is seeking a Utilization Review Specialist to perform reviews for I/DD, mental health, and SUD services. You will assess treatment plans and... ...intensity settings. The role is full-time and remote with occasional local travel within the Kent County...Remote workFull timeLocal area
- Gainwell Technologies LLC is seeking a licensed behavioral health professional to review prior authorization submissions and perform MMIS data entry for... ...WI licensure, with CSAC/SAC preferred. It is a 100% remote, full‑time role offering competitive benefits and ongoing...Remote jobFull time
- ...About Us FHE Health ("FHE") is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...We are seeking an experienced specialist who is passionate about making... ...preferred. 2-3 years of utilization review experience in behavioral health...Remote workDaily paidFull time
- ...Pavilion Behavioral Health System in Champaign, Illinois, is seeking a Full-time Utilization Review Coordinator to ensure accurate chart reviews and to obtain hospital stay certifications from insurers. The role supports behavioral health and addiction treatment across...Full time
- ...New Vista Behavioral Health is seeking a detail-oriented Corporate Utilization Review Specialist to support utilization review and insurance authorization processes across multiple behavioral health facilities. Candidates must hold an active clinical license as an...
$48.78 - $73.17 per hour
...admission, need for continued stay, and proper utilization of physician, nursing, and ancillary services. Responsible for concurrent review on specific patients. Develops,... ...Description:Department Required Education:Behavioral Health: Master's in Social Work or related...Work at officeLocal areaShift work$75k - $90k
...application process. Clinical Reviewer - LCSW, LPC, LCPC - Salem,... ...00.00 Annually This is a remote position based in Salem,... ...passionate about improving access to behavioral health services in the community?... ...evidence-based criteria to utilization management reviews; document...Remote workFull timeContract workWork from home- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across... ...5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
- ...Centene Corp. is seeking a Utilization Review Clinician - Behavioral Health for a remote role in Georgia. Candidates must hold an active Georgia licensed clinician or compact nursing license and have BH experience. The role runs Monday–Friday 8:00 AM to 5:00 PM with...Remote workMonday to Friday
- ...Centene is seeking a remote Utilization Review Clinician – Behavioral Health to support inpatient and outpatient BH Medicare plans. You will perform medical necessity reviews and authorization determinations to ensure members receive appropriate, high-quality BH services...Remote work
- ...Centene Management Company LLC in Texas seeks a experienced Behavioral Health Utilization Reviewer to evaluate and authorize mental health and substance abuse care. The role requires compliance with regulatory guidance and collaboration with BH teams to ensure appropriate...Remote work
- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
$60k - $62k
Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States... ...and expertise. Position Overview The Utilization Review Specialist is responsible for all aspects of the... ...may change as needs evolve. Coronis Health is committed to creating a diverse...Remote workFull timePart timeWork from homeFlexible hours- Centene seeks an Utilization Review Clinician - Behavioral Health for a fully remote role serving New York. You will perform clinical reviews, assess care levels, and authorize mental health/substance abuse services. Requires a clinical license (RN or LMSW/LCSW/LMHC/LPC...Remote workDay shift
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a strong team-oriented environment...Remote workWork at office
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Remote workFull time- ...Ascension is seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical... ...diploma, with benefits including comprehensive health coverage, retirement plans, PTO, and...Remote work
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...Remote work
$65k - $88.6k
Humana Healthy Horizons in Kentucky seeks a remote utilization management behavioral health professional to coordinate, document and communicate decisions about medical services and benefits. The role is remote nationwide and full-time, with a pay range of $65,000 to $8...Remote jobFull time- ...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... ...youth, and adults. This remote, Oregon-based role requires...Remote work
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge... ..., we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health team. This role is ideal for an RN with strong experience...Remote workMonday to FridayWeekend workWeekday work
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