Remote Utilization Review Specialist - Behavioral Health
The Florida House
FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications with insurance payers. You will support patient access by securing initial and continued-stay authorizations, preventing denials, and aligning documentation with payer guidelines. The role emphasizes reimbursement optimization, compliance, and high-quality patient care across behavioral health services. #J-18808-Ljbffr
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant... ...optimization, compliance, and high-quality patient care across behavioral health services. #J-18808-LjbffrRemote work
- ...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
$24 - $26 per hour
...Utilization Review Specialist - Behavioral Health (Remote) PHP/IOP | Full-Time | Monday-Friday, 9 AM-5 PM ET | $24-$26/hour About the Role Principles Recovery Center (PRC) are hiring a Utilization Review (UR) Specialist to manage insurance authorizations for adolescent...Remote workFull timeMonday to Friday- ...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
- ...monitoring the Mental Health Plan and Drug-Medi-... ...-ODS), including review of medical records to ensure proper utilization of treatment... ...clients receiving behavioral health treatment. UR Specialists also interpret, advise... ...option for hybrid remote work may be available...Remote workContract workLocal areaTrial periodFlexible hours
$90.9k - $129.9k
...Apply your expertise to adjudicate Behavioral Health prior authorizations based on medical... ...for this role, rather you will provide utilization review and quality assurance. Your role in... ...should expect in this role ~100% Remote home office. ~ Full-time position....Remote workFull timeWork experience placementHome officeFlexible hours- Principles Recovery Center in Florida is seeking a remote Utilization Review Specialist to manage insurance authorizations for adolescent and adult behavioral health, substance use, and co-occurring treatment in a PHP/IOP setting. You will verify benefits, complete prior...Remote job
- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating for clients to secure maximum authorized treatment days. The role emphasizes communication, organization, data entry, multitasking...Remote work
- Bradford Health Services is seeking an Utilization Review Specialist in Birmingham, AL. The role ensures medical necessity and regulatory compliance across patient care, collaborating with providers, insurers, and case managers to optimize outcomes. The candidate will review...Remote job
- ...About Us FHE Health ("FHE") is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...We are seeking an experienced specialist who is passionate about making... ...preferred. 2-3 years of utilization review experience in behavioral health...Remote workDaily paidFull time
- Row Partners in Utah is seeking a Behavioral Health Utilization Management Specialist to bridge clinical care and insurance coverage. Based in Sandy with hybrid/remote options, you will review records, determine medical necessity, and collaborate with clinicians, payers...Remote work
- Banner Health is seeking a Behavioral Health Utilization Care Manager to authorize initial admissions and perform concurrent reviews for medical necessity. The role involves coordination with hospitals... ...planning. The position is remote, but Arizona residency is required...Remote job
$48.78 - $73.17 per hour
...interested in joining Sutter Health! Organization ABSMC-Alta Bates... ...continued stay, and proper utilization of physician, nursing, and ancillary... .... Responsible for concurrent review on specific patients.... ...REQUIRED EDUCATION Department, Behavioral Health: Master's in Social Work...Full timeWork at officeLocal areaMonday to FridayShift workWeekend work$65k - $88.6k
...Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination... ...and benefit determinations. This remote role requires clinical experience and... ...include coordinating utilization review processes and communicating decisions...Remote job- Alliance Health in Morrisville, NC is seeking an UM Clinical Specialist-Behavioral Health to perform utilization reviews and care management for PHIP-enrolled providers. The role emphasizes... ...with flexibility for a primarily remote schedule and occasional office attendance...Remote jobWork at office
- ...Pavilion Behavioral Health System in Champaign, Illinois, is seeking a Full-time Utilization Review Coordinator to ensure accurate chart reviews and to obtain hospital stay certifications from insurers. The role supports behavioral health and addiction treatment across...Full time
- Behavioral Health Utilization Management Specialist Location: Utah (Hybrid & Remote Options Available) Job Type: Full-time Department: Behavioral Health / Utilization Management... .... What You’ll Do Champion patient care by reviewing medical records and clinical documentation...Remote workFull timeWork at office
- ...New Vista Behavioral Health is seeking a detail-oriented Corporate Utilization Review Specialist to support utilization review and insurance authorization processes across multiple behavioral health facilities. Candidates must hold an active clinical license as an...
- San Jose Behavioral Health seeks a Utilization Review Specialist (Full Time) to support the Utilization Department in an acute psychiatric hospital. Responsibilities include concurrent reviews, pre-certifications, discharge planning, and providing guidance on documentation...Full time
$75k - $90k
...application process. Clinical Reviewer - LCSW, LPC, LCPC - Salem,... ...00.00 Annually This is a remote position based in Salem,... ...passionate about improving access to behavioral health services in the community?... ...evidence-based criteria to utilization management reviews; document...Remote workFull timeContract workWork from home- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across... ...5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
$60k - $62k
Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States... ...and expertise. Position Overview The Utilization Review Specialist is responsible for all aspects of the... ...may change as needs evolve. Coronis Health is committed to creating a diverse...Remote workFull timePart timeWork from homeFlexible hours- ...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 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
- Denver Springs in Englewood, CO, part of Lifepoint Health, is seeking a Registered Nurse (RN), Utilization Review Specialist to join our behavioral health team. You will assess patients, coordinate with the clinical team, and ensure timely admissions and precertifications...Full time
- Advanced Revenue Solutions is seeking an UR Specialist to oversee utilization review and insurance authorizations for SUD treatment at Britelife... ...have 2-3 years of UR or case management experience in behavioral health, knowledge of ASAM criteria, and strong...
- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive pay...Remote work
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...Remote work
- Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication... ..., and collaboration with providers and members, in a remote setting. Requirements include a nursing degree or a...Remote jobWork at office
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