Centene

2 days ago

Utilization Review Clinician - Behavioral Health

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 18 hours agoStatus: Live

Job Summary

Conduct clinical utilization reviews for mental health and substance abuse services, evaluating treatment before, during, and after care to ensure medically appropriate level of care. Perform prior authorization and concurrent inpatient reviews, analyze behavioral health member data to support quality and appropriate utilization, and educate providers and families. Coordinate with behavioral health providers, and engage medical directors and leadership through staffing and integrated rounds.

Location: Arkansas

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Perform clinical review to assess care related to mental health and substance abuse and determine medical appropriateness.
•Evaluate member treatment before, during, and after services to ensure appropriate level of care.
•Complete prior authorization reviews for mental health and substance abuse in accordance with regulatory guidelines and criteria.
•Conduct concurrent review of behavioral health inpatient to assess member needs and support discharge planning.
•Provide education to providers, members, and families regarding the behavioral health utilization process and coordinate with healthcare providers and medical leadership.

Pay and Benefits

Salary: USD 27.02 - 48.55 hourly

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Graduate of an accredited school of nursing or a bachelor’s degree, with 2–4 years of related experience.
•Master’s degree for behavioral health clinicians required.
•License to practice independently and state-required licensure as outlined for the applicable state.
•LCSW, LMHC, LPC, LMFT, LMHP, or RN licensure required (one of the listed options).
•Prior clinical knowledge to review and/or assess treatment plans related to mental health and substance abuse preferred.

Experience:2-4 years

Education:Master's

Licenses:LCSWLMHCLPCLMFTLMHPRN

Company Brief

Centene

Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn

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Centene

2 days ago

Utilization Review Clinician - Behavioral Health

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 18 hours agoStatus: Live

Job Summary

Location: Arkansas

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Perform clinical review to assess care related to mental health and substance abuse and determine medical appropriateness.
•Evaluate member treatment before, during, and after services to ensure appropriate level of care.
•Complete prior authorization reviews for mental health and substance abuse in accordance with regulatory guidelines and criteria.
•Conduct concurrent review of behavioral health inpatient to assess member needs and support discharge planning.
•Provide education to providers, members, and families regarding the behavioral health utilization process and coordinate with healthcare providers and medical leadership.

Pay and Benefits

Salary: USD 27.02 - 48.55 hourly

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Graduate of an accredited school of nursing or a bachelor’s degree, with 2–4 years of related experience.
•Master’s degree for behavioral health clinicians required.
•License to practice independently and state-required licensure as outlined for the applicable state.
•LCSW, LMHC, LPC, LMFT, LMHP, or RN licensure required (one of the listed options).
•Prior clinical knowledge to review and/or assess treatment plans related to mental health and substance abuse preferred.

Experience:2-4 years

Education:Master's

Licenses:LCSWLMHCLPCLMFTLMHPRN

Company Brief

Centene

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn