Utilization Review Clinician - Behavioral Health

4 days ago

United StatesFull TimeHealthcare Administration

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Job Description

About the Role

Join Centene Corporation as a Utilization Review Clinician - Behavioral Health in United States. You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Key Responsibilities

Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.

Master’s degree for behavioral health clinicians required.

Benefits & Compensation

Saturday 8:00 am

License Clinical Social Worker required or LMHC

Licensed Mental Health Counselor required or LPC

Licensed Professional Counselor required or Licensed Marital and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or RN

Work Schedule

Full-time position.

No explicit call, weekend, or night shift information provided.

Apply to join Centene Corporation as a Utilization Review Clinician - Behavioral Health.

Key Skills

Utilization reviewBehavioral healthMental health assessmentSubstance abuse assessmentPrior authorizationConcurrent reviewDischarge planningClinical documentationCare coordinationRegulatory complianceTreatment planningProvider communicationData analysisMedical necessity determination

Requirements

Candidates must hold a Master's degree for behavioral health roles or a Bachelor's degree with 2-4 years of experience, along with an active Oklahoma license (LCSW, LMHC, LPC, LMFT, LMHP, or RN). Applicants are required to be located in Oklahoma to perform this fully remote role.

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Position Insights

Healthcare Administration — healthcare professional Career Context

This Healthcare Administration position at Centene is open to healthcare professional candidates.

Location & Logistics

This position is based in United States.

Skills, Responsibilities & Benefits

Key skills and qualifications: Utilization review, Behavioral health, Mental health assessment, Substance abuse assessment, Prior authorization, Concurrent review, Discharge planning, Clinical documentation. Candidates with experience in these areas may be especially well-suited for this Healthcare Administration role.

Core responsibilities: The clinician performs clinical reviews to assess the medical appropriateness of mental health and substance abuse services. They also conduct prior authorizations, concurrent reviews, and engage with providers to ensure quality care and efficient utilization.

Benefits package: Competitive pay, Health insurance, 401k, Stock purchase plans, Tuition reimbursement, Paid time off, Holidays, Workplace flexibility. A comprehensive benefits package is an important factor in evaluating total compensation beyond base salary.

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