Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Behavioral Health Utilization Reviewer

Comagine Health

Oregon, WI
  • Remote job

Comagine Health is seeking a Clinical Reviewer to work remotely from Oregon with travel across the Eugene and surrounding areas. You will review clinical documentation to determine medical necessity and coordinate assessments via EMR systems, ensuring timely decisions and high-quality care. The role requires licensure, 3 years of direct patient care in behavioral health, and familiarity with utilization review. #J-18808-Ljbffr Comagine Health

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Behavioral Health Utilization Reviewer in Oregon, WI vacancy
  • 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 job
    Full time

    COMAGINE HEALTH

    Portland, OR
    12 hours ago
  • 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 job
    Full time

    Umpqua Health

    Roseburg, OR
    2 days ago
  • 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... 
    Remote job

    Comagine Health

    Oregon, WI
    21 hours ago
  • $130 - $145 per hour

    Hi, we're Oscar. We're hiring a Behavioral Health Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around...  ...Management. Work Location: This position is fully remote and open to candidates residing in the U.S.,... 
    Remote work
    Hourly pay
    Part time
    Work from home
    Home office

    Oscar Health

    New York, NY
    2 days ago
  •  ...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 work
    Contract work
    Work at office

    Excellus BCBS

    Jamestown, NY
    1 day ago
  • $219k - $286.9k

     ...Physician Reviewer - Utilization Management Remote 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 platform and a relentless focus on serving... 
    Remote work
    Full time
    Local area
    Work from home
    Home office
    Weekend work

    Oscar Health

    United States
    3 days ago
  • 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 job
    Full time
    Work from home

    ExamWorks

    New York, NY
    1 day ago
  • $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 job
    Work from home

    Oscar Health

    New York, NY
    2 days ago
  • 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 job
    Work at office
    Work from home

    Nationwide-Children

    Columbus, OH
    21 hours ago
  • 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 job
    Work at office
    Work from home

    Nationwide Children's Hospital

    Columbus, OH
    21 hours ago
  • $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 work
    Hourly pay
    Full time

    Avery Healthcare Group Ltd.

    United States
    1 day ago
  •  ...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

    ChenMed LLC

    New York, NY
    3 days ago
  •  ...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 work
    Price work
    Extra income
    For contractors
    Flexible hours

    Dane Street

    New York, NY
    2 days ago
  • 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 job
    Full time

    Oak Street Health

    Richmond, VA
    1 day ago
  • 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

    ChenMed LLC

    New York, NY
    3 days ago
  •  ...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

    Solving IT

    New York, NY
    1 day ago
  • 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 job
    Full time
    Casual work
    Monday to Friday

    ExamWorks UM Strategies

    New York, NY
    3 days ago
  • 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 job
    For contractors
    Monday to Friday
    Flexible hours

    Dane Street

    Washington DC
    1 day ago
  • $27.02 - $48.55 per hour

     ...: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors...  ...flexibility to work remotely from their home...  ...Performs concurrent review of behavioral health (BH) inpatient...  ...quality and appropriate utilization of services Provides... 
    Remote work
    Hourly pay
    Full time
    Part time
    Work at office
    Work from home
    Monday to Friday
    Flexible hours

    Centene Corporation

    Austin, TX
    3 days ago
  • UnitedHealth Group in California offers a remote-capable role focusing on behavioral health case management. You will handle inbound calls from providers...  ...2+ years of experience. The role emphasizes timely utilization management, benefits explanation across levels of care... 
    Remote job

    Okpsych

    Los Angeles, CA
    2 days ago
  • $65k - $88.6k

     ...Become a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge and skills to support...  .../ HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for... 
    Remote work
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office
    Monday to Friday

    Humana

    United States
    5 days ago
  • $60.52k - $129.62k

     ...Care Plan Reviewer (Clinical Case Manager BH) We're building a world of health around every individual — shaping a more connected...  ...(Clinical Case Manager BH) utilizes advanced clinical judgment and...  ...supports appropriate member behavioral healthcare through review of... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Local area

    Oak St. Health

    United States
    4 days ago
  • 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

    P32HS Point32Health Services Inc

    Canton, MA
    3 days ago
  •  ...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 work
    Monday to Friday
    Flexible hours
    Weekend work

    AmeriHealth Caritas

    Newtown Square, PA
    21 hours ago
  • CVS Health is hiring a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. You will evaluate preauthorization requests, coordinate decisions with providers, and manage crisis calls when needed. Ideal candidates will hold an active BH... 
    Remote job

    CVS Health

    California, MO
    11 hours ago
  • 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

    Fherehab

    Deerfield Beach, FL
    4 days ago
  • $87.7k - $157.8k

     ...on our Medical Management/Health Services team. Centene is...  ...Description Centene is Hiring – Remote Psychologist Reviewers (ABA) Centene is seeking...  ...Reviewers (Applied Behavior Analysis). Candidates...  ...best practice models and utilization management processes Interact... 
    Remote work
    Full time
    Part time
    Work at office
    Flexible hours

    Centene Corporation

    Sacramento, CA
    4 days ago
  • 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, SED... 
    Remote work

    Sentara Health

    Richmond, VA
    2 days ago
  • $86k - $154.7k

     ...for the Psychologist Reviewer role at RemoteWorker...  ...our Medical Management/Health Services team. Centene...  ...Centene is hiring a Remote Psychologist – Join Our...  ...for improving access to behavioral health care? Centene...  ...well as participating in Utilization Management clinical... 
    Remote work
    Full time
    Work at office
    Relocation package
    Flexible hours

    RemoteWorker US

    Brooklyn, NY
    4 days ago
  • 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

    Sentara Health Plan PG

    Fredericksburg, VA
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Behavioral Health Utilization Reviewer. Be the first to apply!