Remote Utilization Review Specialist - Behavioral Health
Santa Barbara Cottage Hospital
FHE Health is seeking an experienced UR Specialist to manage clinical authorizations with insurers, ensuring timely communication and adherence to payer guidelines. You will support patient access by securing initial and continued authorizations and collaborating with clinical teams to document medical necessity. Join a team focused on compliant, high-quality care in behavioral health, with responsibilities centered on maximizing reimbursement and maintaining rigorous documentation standards. #J-18808-Ljbffr
- 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
$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- 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
- 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
$45k - $55k
...Careers That Change Lives Compass Health Center is a recognized leader in crisis... ...through an intermediate level of behavioral healthcare. Beyond our genuine... ...position, clickhere . Back to jobs Utilization Review Specialist Remote Weekly outpatient therapy isn't always...Remote workWork at office$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- ...mattersMesa Springs is part of Lifepoint Health, a diversified healthcare delivery... ...exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a... ...about Mesa SpringsMesa Springs is a behavioral health hospital offering exceptional...Temporary workPart timeRelief
$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$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$51 per hour
Job Title: Utilization Review Specialist (BCBA Licensee) Location: Baltimore, MD (Remote - offsite) Type: Contract To Hire Compensation:... ...and appropriateness of Applied Behavior Analysis (ABA) services. This... ..., and medical/behavioral health policies to support determinations...Remote workContract workWork at officeLocal areaWork from home- ...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$45k - $55k
...and their families rely on Compass Health Center when in crisis – every day,... ...About This Role We are seeking a REMOTE Utilization Review Specialist to obtain appropriate insurance... ...authorization for our patients to receive Behavioral Health treatment at high levels of...Remote workFull timeWork at office$62k - $70k
...Why Charlie Health? Millions of people across the... ...lacks personalization, behavioral healthcare can leave... ...is to ensure that the utilization process is thorough, organized... ...peer to peer reviews with insurance MDs to... ...sponsored benefits. #LI-REMOTE Please note that this...Remote workFull timeLocal area- HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role... ...and a strong collaboration with physicians and care teams. Remote work is available after training. #J-18808-Ljbffr...Remote job
- 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
- 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...
- 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
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...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
$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
- ...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
$27.02 - $48.55 per hour
...our Medical Management/Health Services team. Centene... ...Performs a clinical review and assesses care related... ...concurrent review of behavioral health (BH) inpatient... ...quality and appropriate utilization of services... ...approach to work with remote, hybrid, field or office...Remote workHourly payFull timeContract workPart 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
- ...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
$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
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