Utilization Review Clinician - Behavioral Health

Centene

Missouri, US
Base: $27.02 - $48.55 ph; bonus/equity: not specif...
Hybrid
Conduct prior authorization reviews
Perform concurrent inpatient reviews
Assess mental health treatment plans
The role involves performing clinical reviews to determine the medical appropriateness of mental health and substance abuse care levels

Job Summary

  • The role involves performing clinical reviews to determine the medical appropriateness of mental health and substance abuse care levels.
  • Candidates must reside in Missouri despite the position being remote, as the company serves 28 million members.
  • Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K, and flexible work schedules.

Matching Summary

The role involves performing clinical reviews to determine the medical appropriateness of mental health and substance abuse care levels.

Salary

Base: $27.02 - $48.55 per hour; Bonus/Equity: Not specified; Benefits: Health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off

Skills & Requirements

Must-have

  • Conduct prior authorization reviews
  • Perform concurrent inpatient reviews
  • Assess mental health treatment plans
  • Evaluate substance abuse care appropriateness
  • Collaborate with healthcare providers

Nice-to-have

  • Experience with integrated rounds
  • Data analysis for quality improvement
  • Education of members and families
  • Engagement with medical directors

Key Requirements

  • Master's degree in Behavioral Health required
  • State licensure as LCSW, LMHC, LPC, LMFT, or RN
  • 2-4 years of related clinical experience
  • Graduate of an Accredited School Nursing or Bachelor's degree

Work Rights

Must reside in State of Missouri

Tailored Resume

Cover Letter