Remote Behavioral Health Utilization Review Clinician
Centene Corp.
A complete application in a minute
Tailored resume and cover letter, ready to send.
Job summary
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 rotating holidays and weekends, and involves prior authorizations, concurrent reviews, and education of providers and families. The ideal candidate has strong communication, organizational skills, and knowledge of BH utilization
Qualifications
- Graduate or RN with a bachelor’s degree and 2–4 years of related experience.
- Master’s degree in behavioral health is required for clinicians.
- Georgia licensure or compact license to practice.
Responsibilities
- Evaluate BH member treatment to ensure level of care is appropriate.
- Perform prior authorization reviews for mental health and substance use.
- Conduct concurrent BH inpatient reviews and discharge planning.
- Educate providers, members and families on BH utilization processes.
- Interact with BH providers and discuss level of care and services.
- Present cases in staffing and integrated rounds.
- Comply with all policies and standards.
Skills
Education
Job description
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 rotating holidays and weekends, and involves prior authorizations, concurrent reviews, and education of providers and families. The ideal candidate has strong communication, organizational skills, and knowledge of BH utilization
'/%3e%3cpath%20d='M101.744%2012.4726L102.894%2016.1947L99.0021%2013.2201L101.744%2012.4726ZM105.3%208.40937H100.488L99.0026%203.59473L97.5116%208.41047L92.7%208.40385L96.5965%2011.3834L95.1055%2016.1942L99.0021%2013.2196L101.408%2011.3834L105.3%208.40992V8.40937Z'%20fill='white'/%3e%3cdefs%3e%3clinearGradient%20id='paint0_linear_5593_1381'%20x1='90'%20y1='9.44471'%20x2='99'%20y2='9.44471'%20gradientUnits='userSpaceOnUse'%3e%3cstop%20stop-color='%2300AD70'/%3e%3cstop%20offset='0.998594'%20stop-color='%2300B67A'/%3e%3cstop%20offset='1'%20stop-color='%23DCDCE6'/%3e%3c/linearGradient%3e%3c/defs%3e%3c/svg%3e){kind=small}
