Remote Behavioral Health Utilization Review Clinician
Centene Corporation
- Remote job
Centene Corporation is seeking a clinical reviewer to assess mental health and substance use care, including prior authorization and concurrent BH reviews. The role ensures the level of care is medically appropriate and coordinates with providers and families. This remote position supports working from home anywhere in the Central Time Zone, with a weekday schedule 8:00 AM to 5:00 PM and occasional weekend/holiday coverage as needed. #J-18808-Ljbffr Centene Corporation
$27.02 - $48.55 per hour
...Mental Health And Substance Abuse Clinical Reviewer Position Purpose: Performs... ...flexibility to work remotely from their home... ...concurrent review of behavioral health (BH)... ...quality and appropriate utilization of services... ...behavioral health clinicians required. Clinical...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- Centene Corporation is seeking a Behavioral Health Reviewer to assess and authorize mental health and substance abuse care across the care continuum... ...and relevant licensure; master’s degree for behavioral health clinicians is preferred. #J-18808-Ljbffr Centene CorporationRemote job
- Centene Corporation seeks a Clinical Reviewer focused on mental health and substance use care. The role... ...providers and leadership. The position is remote within the Central Time Zone, with... ...and state licensure; Master’s in Behavioral Health preferred. #J-18808-Ljbffr Centene...Remote job
- Centene Management Company LLC is seeking a remote Behavioral Health Reviewer to assess mental health and substance use care from home within the Central Time Zone. You will review level of care, perform prior authorizations, and help plan discharges while coordinating...Remote job
- ...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 jobFlexible hours
- 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
- 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
- ATHENA Consulting is seeking a part-time Utilization Manager Clinician for a remote role based in Hanover, MD. The position reviews behavioral health services and coordinates case management to optimize member outcomes, requiring MD licensure and a health professional...Remote jobPart timeFlexible hoursWeekday work
- ...Comagine Health is seeking a Clinical Reviewer to work remotely from Oregon with travel across the Eugene and surrounding areas. You will... ...requires licensure, 3 years of direct patient care in behavioral health, and familiarity with utilization review. #J-18808-Ljbffr...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
$80.47k - $94.55k
...UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR 9... ...Full-Time, Exempt About Umpqua Health At Umpqua Health, we’re more than... ...through primary care, specialty care, behavioral health services, and care...Remote workFull timeWork at officeLocal areaImmediate startMonday to FridayFlexible hours$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- Centene is seeking a Utilization Review Clinician to assess mental health and substance use care across the continuum. Two schedules are available, with 10... ...times: 8:00 or 9:00 AM ET. Requires RN or Master’s in Behavioral Health, 2-4 years of related experience, and...Remote jobShift work
- ...Utilization Review NurseThis position has a remote option for those living close and will be able to come into the hospital... ...with other members of the health care team to ensure the above according... ...'s member's health care for behavioral health care management.Follow CHRISTUS...Remote workFull time
- ...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 workFull time
- 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
$66.83k - $111.38k
...First (Days) Overview: Sentara Health Plansis hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote! Status: Full-time,permanent position (... ...wellness programs, and integrated clinical and behavioral health services-all to help our members improve...Remote workPermanent employmentFull timeTemporary workShift workDay shift- Registered Nurse (RN) - Utilization Review Job Description Job Shift:Days... ...help patients achieve optimal health, access to care, and appropriate... ...years of acute hospital or behavioral health patient care... ...Thop Transmountain Campus (Remote) #J-18808-Ljbffr Oracle CorporationRemote workFull timeWork at officeFlexible hoursShift work
- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- 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 jobFull timeWork from home
- ...Registered Nurse- Transplant Utilization Review Founded in 1999 and... ...members of Quantum Health’s employer groups in... ...flexibility. Fully remote if live >50 miles... ...transfer of cases for behavioral health management when... ...independently. Where applicable, clinicians must hold a Multi‑...Remote workPermanent employmentCasual work
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...an accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
- 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
$40.12 - $62.19 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty service line of physician advisors... ...information. This is a Full-time remote position. Responsibilities:... ...hire, plus wellness programs and mental health support 403(b) retirement plan with...Remote workFull time- ...This is a great opportunity for a local remote position. Schedule PRN (As needed)... ...support all units/staff (commercial, behavioral health, inpatient, etc). Requirements: 2 years... ...hospitalized patients. 2 years of utilization review (UR) experience reviewing hospital admissions...Remote workReliefLocal areaMonday to FridayFlexible hoursShift work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels... ...Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable). InterQual...Remote work
- ...Registered Nurse - Utilization Review About Company Bestica: We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...Remote work
$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 jobWork from home- ...R1 RCM is seeking an experienced Utilization Review Author (RN) for our Physician Advisory Team. The role involves first-level admission and continued stay reviews using InterQual/MCG criteria and requires hospital-based UR or Case Management experience. The position...Remote workFlexible hours
- ...effective patient management, the full-time Registered Nurse Utilization Review will conduct initial and concurrent reviews of medical... ...optimize reimbursement, and prevent payment denials while working remotely. Key responsibilities Reviews and evaluates clinical...Remote workFull time
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