Utilization Review Specialist - Behavioral Health (Remote)
$50kAdvanced Recovery Systems LLC
Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50,000 per year, based on experience Free Teladoc access and visits for employees and eligible dependents Comprehensive benefits beginning on the 1st day of the month following the date of hire Matching HSA contributions of up to $1,500 per year Employee Referral Bonus of up to $4,000 Opportunity to make a tangible difference in the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent reviews Schedule peer-to-peer reviews and coordinate urgent/expedited appeals Staff individual cases with medical doctors as required Maintain compliance with all standard utilization review policies and procedures What is Required (Qualifications) Bachelor’s degree in a health or behavioral health-related field required; graduate degree preferred High School diploma or equivalent and a state license (e.g., Registered Nurse, Licensed Practical Nurse, LCSW, LMHC) preferred Minimum of three years’ experience in a psychiatric or chemical dependency setting Minimum of three years’ utilization review experience preferred State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor) How to Stand Out (Preferred Qualifications) Experience in behavioral health management or addiction treatment settings Familiarity with ASAM criteria and utilization review processes Strong organizational skills and ability to manage multiple tasks under pressure Excellent communication skills with managed care companies Proactive problem-solving skills in a healthcare environment #BehavioralHealth #UtilizationReview #HealthcareJobs #MentalHealth #CareerGrowth #J-18808-Ljbffr
- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...Remote work
$55k - $70k
...hands-on, process-driven operational support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $55,000... ...must have prior UR & clinical experience. Remote hires and applicants without prior...Remote workFull timeWork at office- 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
- ...FHE Health Job OpportunityFHE Health is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...are seeking an experienced specialist who is passionate about... ...required preferred.2-3 years of utilization review experience in behavioral...Remote workDaily paidFull time
$41.6k - $47k
...Utilization Review SpecialistAt Umpqua Health, we're more than a healthcare organization we're... ...primary care, specialty care, behavioral health services, and... ....The Utilization Review Specialist supports Umpqua Health... ...organized and productive in a remote, independent work...Remote workWork at officeLocal areaImmediate startMonday to FridayShift work$51 per hour
...Utilization Review Specialist (BCBA Licensee)Baltimore, MD (Remote – offsite) Contract To Hire $51/hr (W2) 100% Remote Must be Licensed... ...and appropriateness of Applied Behavior Analysis (ABA) services. This... ..., and medical/behavioral health policies to support determinations...Remote workContract workWork at officeWork from home$51 per hour
...Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote – offsite) Type: Contract To Hire Compensation... ...appropriateness of Applied Behavior Analysis (ABA) services.... ..., and medical/behavioral health policies to support determinations...Remote workContract workTemporary workWork at officeLocal areaWork from home$27.07 - $33.37 per hour
Bakersfield Behavioral Healthcare Hospital in Bakersfield, California, seeks a Utilization Review Specialist to review medical records, prepare clinical appeals, and coordinate certifications with managed care. Requires High School Diploma, current California LVN license...Hourly pay- ...Alliance Health is seeking a UM Clinical Specialist-LTSS for full-time remote work, NC-based. You will perform utilization reviews and authorizations for I/DD and TBI waivers, ensuring services meet clinical guidelines and are provided in the least restrictive setting....Remote workFull time
$39.4 - $53 per hour
...revenue cycle management solutions for health systems, including hospitals and... ...other weekend We are seeking Virtual Utilization Review Specialists to join our team. Essential job... ...and Abilities Required: This is a remote role which requires access to high speed...Remote workTemporary workWork at officeLocal areaMonday to FridayWeekend work$65k - $85k
...Utilization Review Specialist (RN) – RemoteAt Concierge Home Care, 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 in OASIS, coding, QA, and home health...Remote workMonday to FridayWeekend work- ...Job Description Job Description Behavioral Health Utilization Management Specialist Location: Utah (Hybrid & Remote Options Available) Job Type: Full-time Department... ...You ’ll Do Champion patient care by reviewing medical records and clinical documentation...Remote workFull timeWork at office
- HonorHealth is seeking a Utilization Review RN Specialist to review and monitor health care utilization, ensuring medical necessity and appropriate levels of care... ...driving accurate documentation for data reporting. Remote work is available after training, with a day shift...Remote jobDay shift
- Ascension Sacred Heart Hospital is seeking a nurse to join our Utilization Management team in a remote role. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and alignment with reimbursement policies. Join a multidisciplinary...Remote job
- Memorial Physician Practices is hiring a Utilization Review Specialist in Tucson, Arizona, who will facilitate clinical reviews and advocate for patients accessing mental health services. This PRN role involves working with managed care organizations and is vital for ensuring...Relief
- Evolve Treatment Centers in West Palm Beach, Florida, is seeking a full-time Utilization Review Specialist. This role involves initiating pre-certification authorizations, communicating with facilities, and maintaining patient census. Candidates should have a High School...Full time
- Northwestern Memorial Healthcare is seeking a Utilization Reviewer to join their team. Responsibilities include managing utilization review calls, advocating for patients with insurance companies, and coordinating efforts to appeal unfavorable decisions. The ideal candidate...
- Ensemble is seeking Virtual Utilization Review Specialists to join our remote team. You will evaluate medical necessity, coordinate with physician advisors, and collaborate with care management and financial clearance teams to ensure high-quality patient care and appropriate...Remote job
$18.13 - $29.9 per hour
...Behavior Health Specialist I Position is home based. Under the direction of IBT Coordinator and Clinical... ...care planning & treatment team review process under the direction of the Clinical... ...in a safe, effective manner, utilizing the least restrictive, safe patient care...Remote workDaily paidWork from homeShift work$29.62 - $45.31 per hour
...Description Providence Health Plan caregivers are not simply valued – they’re invaluable... ...Department Coordinate and execute the review and research functions required to... ...inquiries, provider resolutions, etc.) Remote Work This position offers 100% remote...Remote workMinimum wageFull timeWork experience placementLocal areaShift work- ...ABA Utilization Review SpecialistSpectrum Billing Solutions offers industry... ...Utilization Review (UR) Specialist to our growing team. The... ...environment. This is a fully remote or office/home hybrid... ...years of related ABA and/or Behavioral Health experience.Bachelor's or master...Remote workWork at officeFlexible hours
- ...Remote Authorization SpecialistThis role manages... ...certifications, concurrent reviews, verifying benefits,... ...by a payer issue.Utilization Review · Insurance Authorization... .../Precertification · Behavioral Health Case ManagementVerify... ...a UR/authorization specialist at the PHP and IOP...Remote work
$27.02 - $48.55 per hour
...our Medical Management/Health Services team. Centene... ...Texas Outpatient Behavioral Health Experience Position... ...Performs a clinical review and assesses care... ...quality and appropriate utilization of services... ...approach to work with remote, hybrid, field or office...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...Utilization Review Specialist | Remote | Full-TimeBanyan Treatment Centers is seeking an experienced and detail... ...facing substance use and mental health disorders. Backed by TPG, one of the... ...environmentPreferred:Graduate degree in a health or behavioral health related fieldClinical...Remote workTemporary work
- ...purpose-driven leadership. At Bradford Health Services, we are committed to... ...digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching... ...people. About the Role: The Utilization Review Specialist plays a critical role in ensuring...Remote workPart time
- ...Behavioral Health SpecialistAs a Behavioral Health Specialist, you will be part of an integrated care team... ...opportunities for both remote and on-site work.Professional... ...use disorders.Utilizes evidence-based treatment... ...policies.Participates in peer review processes, agency...Remote workWork at officeFlexible hours
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based... ...relevant medical setting, and the ability to work in a remote environment. Comprehensive benefits are provided, including...Remote workContract workWork from home
- ...tasks related to preadmission reviews, continued stay reviews,... ...least restrictive environment, utilizing proven clinical interventions... ...Screening for co-occurring mental health conditions. Supports... ...leadership. Workplace Behaviors Demonstrates the ability...Remote workWork at office
$36 per hour
...Position Summary: The Behavior Intervention Specialist (BIS) will assess and... ...respect and dignity and to utilize person centered supports designed... ...Support Plan (BSP) and reviews semi-annually and updates... ...on the agency's electronic health platforms, i.e....Remote workLocal area- ...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 workFlexible hours
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