Utilization Review Clinician - Behavioral Health
Remote-GAremote$56K – $101K
Posted today · via Workday
About this role
Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate. Key Details: Centene is seeking a remote Utilization Review Clinician – Behavioral Health to support our inpatient and outpatient Behavioral Health Medicare Plan. In this role, you will perform medical necessity reviews and authorization determinations to help ensure members receive appropriate, high-quality behavioral health services. Behavioral health and/or utilization management experience is preferred, along with strong knowledge of medical necessity criteria and managed care principles.…
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
For this role: monday, teams
2
Level fit
We check your title trajectory against the seniority signal of the role.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible. We factor in your stated location and time-zone overlap.
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Skills in this role
Pulled from the job description. These are the keywords we'll weight when scoring your fit.
mondayteams
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