Remote Behavioral Health Utilization Review Clinician

IntelliResume; Louisiana (MO); On-site; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Flexible work schedules

Job summary

Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assessments related to mental health and substance use, ensuring care levels are appropriate and medically necessary.

Based in Louisiana, this remote, full-time role offers day shifts, competitive pay, and benefits including health insurance, 401K and tuition reimbursement, with residency required in LA. Collaborative work with providers and care teams to optimize utilization is expected.

Qualifications

• 2-4 years of related experience preferred
• Clinical knowledge and ability to review treatment plans related to mental health and substance abuse preferred
• Experience working with providers and healthcare teams preferred

Responsibilities

• Evaluate member's treatment for mental health and substance abuse before, during, and after services.
• Perform prior authorization reviews related to mental health and substance abuse.
• Conduct concurrent reviews of behavioral health inpatient cases.
• Analyze behavioral health member data to improve service utilization.
• Provide education to providers, members, and their families regarding behavioral health utilization processes.
• Interact with behavioral health healthcare providers to discuss levels of care.

Skills

Clinical reviews

Behavioral health

Interprofessional collaboration

Education coordination

Education

Bachelor's degree

Master's degree

Job description

Centene is seeking an Utilization Review Clinician - Behavioral Health to perform clinical reviews and assessments related to mental health and substance use, ensuring care levels are appropriate and medically necessary.

Based in Louisiana, this remote, full-time role offers day shifts, competitive pay, and benefits including health insurance, 401K and tuition reimbursement, with residency required in LA. Collaborative work with providers and care teams to optimize utilization is expected.