Remote Otter LogoRemoteOtter

Utilization Review Clinician - Behavioral Health - Remote

Posted 2 days ago
Healthcare
Full Time
USA
$26.50 - $47.59/hour

Overview

As a Utilization Review Clinician in Behavioral Health, you will play a crucial role in assessing and monitoring the care related to mental health and substance abuse for our members, ensuring that services provided are medically appropriate.

In Short

  • Perform clinical reviews and assessments for mental health and substance abuse care.
  • Monitor and determine the appropriateness of care levels and services.
  • Conduct prior authorization reviews in accordance with regulatory guidelines.
  • Analyze member data to enhance service quality and utilization.
  • Educate providers and members about the behavioral health utilization process.
  • Engage with healthcare providers to discuss care levels and services.
  • Collaborate with medical directors to improve care quality and efficiency.
  • Formulate and present cases in staffing and integrated rounds.
  • Comply with all policies and standards.
  • Work Monday to Friday, 8 AM to 5 PM PST.

Requirements

  • Graduate of an Accredited School of Nursing or Bachelor's degree.
  • 2 – 4 years of related experience.
  • State licensure as required (LCSW, LMHC, LPC, LMFT, LMHP, or RN).
  • Master’s degree for behavioral health clinicians is required.
  • Preferred knowledge of mental health and substance abuse utilization review process.
  • Experience working with healthcare teams in mental health and substance abuse.

Benefits

  • Competitive pay and health insurance.
  • 401K and stock purchase plans.
  • Tuition reimbursement.
  • Paid time off plus holidays.
  • Flexible work schedules (remote, hybrid, field, or office).
Centene Management Company logo

Centene Management Company

Centene Management Company LLC is a diversified national organization dedicated to transforming the health of communities by providing high-quality healthcare solutions to its 28 million members. With a focus on building strong partnerships between health plans and provider networks, Centene emphasizes optimal performance in care delivery, quality improvement, and cost utilization. The company values diversity and offers a comprehensive benefits package, including competitive pay, flexible work arrangements, and support for employee development. Centene is committed to helping individuals and families live healthier lives through innovative programs and a wide range of health solutions.

Share This Job!

Save This Job!

Similar Jobs:

Centene Management Company logo

Utilization Review Clinician - Behavioral Health - Remote

Centene Management Company

6 weeks ago

Join our team as a Utilization Review Clinician to assess and improve mental health and substance abuse care for our members.

USA
Full-time
All others
$26.50 - $47.59/hour
Centene Management Company logo

Senior Utilization Review Clinician - Behavioral Health - Remote

Centene Management Company

6 weeks ago

Join Centene as a Senior Utilization Review Clinician to assess and ensure the quality of mental health and substance abuse services for members.

USA
Full-time
All others
$30.00 - $54.03/hour

M.S

Behavioral Health Utilization Management Clinician - Remote

Morgan Stephens

10 weeks ago

Join a leading healthcare organization as a remote Behavioral Health Utilization Management Clinician to ensure quality care for behavioral health services.

Worldwide
Contract
All others
$42/hour

Highmark

Behavioral Health Clinician - Remote

Highmark

3 weeks ago

The Behavioral Health Clinician provides evaluation and therapy for acute psychiatric patients, ensuring compliance with regulatory standards.

USA
Full-time
All others
United Community & Family Services logo

Behavioral Health Clinician - Remote

United Community & Family Services

19 weeks ago

UCFS is seeking a full-time Behavioral Health Clinician to provide intensive gambling treatment services and support individuals and families.

CT, USA
Full-time
Human Resources