Utilization Review Clinician - Behavioral Health

Centene

Remote, US
Base: $27.02 - $48.55 ph; bonus/equity: not specif...
Hybrid
Behavioral health utilization
Medical appropriateness assessment
Prior authorization reviews
Performs clinical reviews to assess care related to mental health and substance abuse, determining medical appropriateness of services

Job Summary

  • Performs clinical reviews to assess care related to mental health and substance abuse, determining medical appropriateness of services.
  • Conducts prior authorization and concurrent reviews for behavioral health inpatient services to ensure optimal member care and discharge planning.
  • Centene offers competitive benefits including health insurance, 401K, tuition reimbursement, and a flexible approach to work with remote options.

Matching Summary

Performs clinical reviews to assess care related to mental health and substance abuse, determining medical appropriateness of services.

Salary

Base: $27.02 - $48.55 per hour; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • Behavioral Health Utilization
  • Medical Appropriateness Assessment
  • Prior Authorization Reviews
  • Concurrent Review
  • Provider Interaction

Nice-to-have

  • Quality Improvement
  • Member Education
  • Team Collaboration

Key Requirements

  • Indiana Licensure Required
  • Graduate of Accredited School Nursing or Bachelor's degree
  • 2-4 years of related experience
  • Master's degree for behavioral health clinicians
  • LCSW, LMHC, LPC, LMFT, LMHP, or RN license

Work Rights

Indiana Licensure

Tailored Resume

Cover Letter