Remote Behavioral Health Utilization Review Clinician II
Walker Healthforce, Inc.
Walker Healthforce, Inc. is seeking a Care Review Clinician II with 2-4 years of clinical practice to perform inpatient and outpatient behavioral health utilization reviews and support medical necessity decisions.
This is a remote contract role. In this position, you will review cases, complete concurrent reviews and prior authorizations, and collaborate with providers, medical directors, and interdisciplinary care teams while maintaining compliant records.
#J-18808-Ljbffr- ...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 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
- ...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 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
$27.02 - $48.55 per hour
...Performs a clinical review and assesses care... ...to mental health and substance abuse... ...concurrent review of behavioral health (BH)... ...and appropriate utilization of services Provides... ...health clinicians required. Clinical... ...approach to work with remote, hybrid, field or...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...BlueShield of South Carolina is seeking a Remote RN Medical Reviewer II to perform medical reviews using... ...guidelines. You will review home health and hospice documentation, determine... ...medical necessity, and support claims and utilization practices in a work-from-home setup....Remote workWork from home
- ...Centene Corporation is seeking a remote Clinical Review Nurse to assess mental health and substance use care. The role monitors level of care, performs prior... ..., and collaborates with providers to optimize BH utilization. A nursing degree plus 2–4 years of related experience...Remote work
- ...CS506 - Behavioral Health Clinician II - Full Time - Exempt972 Mission Street - San... ...engagement with clients, remote work or work-from-home arrangements... ...management. Develop, review and revise treatment plans... ...is an updated PURQC (utilization review) for every open Medi...Remote workPermanent employmentFull timeInterim roleImmediate startWork from home
- ...Care Review Clinician II | Remote | Contract Business & Care Management Long Beach , California Contract Nov 6, 2026 Walker Healthforce... ...practice to conduct inpatient and outpatient behavioral health utilization reviews and support medical necessity decisions. This...Remote workWeekly payContract workWork at officeImmediate start
- ...Experience in both medical and behavioral health and/or substance use... ...~ Work-life balance. ~ Remote setting ROLE DESCRIPTION... ...: This individual will utilize clinical knowledge and communication... ...decision to a second level reviewer. This individual interfaces...Remote workTemporary workWork at officeMonday to FridayFlexible hours
- ...CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment.The position offers 40 weekly...Remote workShift work
- ...Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to manage utilization reviews across states, ensuring medical necessity and policy compliance. Remote work is available with state licensure requirements to maintain. The role emphasizes collaboration...Remote work
- ...Cambia Health Solutions is hiring a licensed Behavioral Health Clinician to join the Utilization Management team. This role focuses on prospective, concurrent, and retrospective reviews to ensure medical necessity and efficient care. The candidate will apply evidence...Remote work
- ...Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to lead utilization management reviews and collaborate with interdisciplinary teams to ensure medically necessary... ..., and document thoroughly in a remote-friendly environment. Qualifications...Remote work
- ...treatment plans for mental health and substance abuse, the... ...full-time New York Licensed Utilization Review Clinician will perform clinical... ...concurrent reviews while working remotely Monday through Friday from... ...and concurrent reviews of behavioral health services Analyzes...Remote workFull timeMonday to Friday
- ...Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to perform utilization management reviews (prospective, concurrent, retrospective) for members in the US states including WA, OR, ID, UT. This remote role emphasizes collaboration with physician...Remote work
- ...Spectraforce Technologies, Inc. is seeking a Utilization Review Clinician - ABA to manage a large caseload, conduct monthly outreach, and coordinate... ...and CRM systems. Required BCBA certification and Licensed Behavior Analyst credentials, plus 2–4 years of related experience....Remote work
$28 - $35 per hour
...A-Line Staffing is hiring a Utilization Review Clinician - ABA (Behavior Analyst) to support a Major Health Plan in Georgia. This remote role follows a M-F schedule, 8:00 AM-5:00 PM EST, and offers hourly pay between $28 and $35 based on experience. The clinician will...Remote workHourly pay- ...Title: Utilization Review Clinician - ABA Duration: 3 Months - Contract-to-Hire Location: Remote - GA Mon-Fri | 8A-5P EST Position Summary... ...to support positive health and care outcomes. Participate... ...: BCBA - Board Certified Behavior Analyst Preferred:...Remote workContract work
$49.42k - $107.1k
...compact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH Medicaid... ...or previous experience with Utilization Reviews. WORK SCHEDULE:... ...work schedule. This is a remote position. Home office with internet...Remote workFull timeWork at officeHome officeMonday to Friday$75k - $90k
...process. Clinical Reviewer - LCSW, LPC, LCPC - Salem... ...This is a remote position based in Salem... ...improving access to behavioral health services in the community... ...evidence-based criteria to utilization management reviews;... ...Refer cases to other clinicians when appropriate...Remote workFull timeContract workWork from home$132.5k - $265k
...individual to join our Government Health Consulting (GHC)team at... ...per week in the office. Remote working requests will be... ...Senior Medical Consultant II – Behavioral Health Clinician, you will play a vital... ...and post-implementation reviews; managed care reporting, monitoring...Remote workMinimum wageFor subcontractorWork at officeFlexible hours3 days per week- ...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
$54.1k - $116.76k
...We’re building a world of health around every individual — shaping... ...one community at a time. Behavioral Health Precertification / Utilization Management Clinician 100% Remote | Monday–Friday | 12:00 PM –... ...and play a critical role in reviewing behavioral health...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayWeekday work- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant... ..., compliance, and high-quality patient care across behavioral health services. #J-18808-Ljbffr...Remote 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
- ...Managing insurance authorizations for mental health and substance use treatment, the full-time Behavioral Health Utilization Review Specialist will verify benefits, complete... ...support medical necessity criteria while working remotely. Key responsibilities Verify insurance...Remote workFull time
$3,268 per week
...RN - Case Management/Utilization Review - Case Management American... ...cases across the health system and patients in... ...onsite and 3 days remote per week Floats between... ...~ Trauma Level I and II experience preferred... ...retrospective review ~ Behavioral health, ambulatory,...Remote workWeekly payContract workLocal areaShift workNight shiftDay shift3 days per week- ...Description: Clinicians will be paid a... ...to improve the health and well-being... ...First Clinician II provides intensive... ...of the child’s behaviors. UCFS... ...travel with 25% remote time. Expected... ...treatment plan reviews based on assessments... ...itself in utilizing a supportive team...Remote workLocal areaWork from homeRelocation packageMonday to FridayNight shiftWeekend work
$24 - $28 per hour
...Utilization Review Specialist – Behavioral Health (Remote) PHP/IOP | Full-Time | Monday–Friday, 9 AM–5 PM ET | $24–$28/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for...Remote workFull timeMonday to Friday
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