OR · Remote
$27.02 - $48.55/hr
Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular ... Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ...
OR · Remote
$27.02 - $48.55/hr
Position is remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Occasional weekends and a regular ... Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ...
Our Investment in You: · Full-time remote work · Competitive salaries Key Responsibilities: · ... review, ensuring decisions align with clinical best practices and organizational values. · ...
Our Investment in You: · Full-time remote work · Competitive salaries Key Responsibilities: · ... review, ensuring decisions align with clinical best practices and organizational values. · ...
... White Health (BSWH). This role ensures effective assessment, validation, and documentation of ... Oversees a workforce that is primarily comprised of remote BSWH employees but also includes global ...
... White Health (BSWH). This role ensures effective assessment, validation, and documentation of ... Oversees a workforce that is primarily comprised of remote BSWH employees but also includes global ...
Roseburg, OR · On-site +1
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...
Roseburg, OR · On-site +1
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...
Salem, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Salem, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Bend, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Bend, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Portland, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Portland, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Medford, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
Medford, OR · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Other roles as assigned. #LI-Remote Pay ranges vary based on the candidate's work location. The ...
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or ...
OR · Remote
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or ...
OR · Remote
$55K - $67K/yr
We're a mission-driven team working to expand access to life-saving behavioral healthcare for ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
OR · Remote
$55K - $67K/yr
We're a mission-driven team working to expand access to life-saving behavioral healthcare for ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
OR · Remote
$59K - $80K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
OR · Remote
$59K - $80K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
OR · On-site +1
$120K - $130K/yr
Remote Reporting to: Chief Financial Officer The Director of Payer Compliance is a senior ... Behavioral health operations, utilization review, or revenue cycle * Working directly with ...
OR · On-site +1
$120K - $130K/yr
Remote Reporting to: Chief Financial Officer The Director of Payer Compliance is a senior ... Behavioral health operations, utilization review, or revenue cycle * Working directly with ...
OR · On-site +1
$120K - $130K/yr
Remote Reporting to: Chief Financial Officer The Director of Payer Compliance is a senior ... Behavioral health operations, utilization review, or revenue cycle * Working directly with ...
OR · On-site +1
$120K - $130K/yr
Remote Reporting to: Chief Financial Officer The Director of Payer Compliance is a senior ... Behavioral health operations, utilization review, or revenue cycle * Working directly with ...
OR · Remote
$72K - $98K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
OR · Remote
$72K - $98K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Review, research and authorize requests for authorization of elective, direct, ancillary, urgent ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...
Review, research and authorize requests for authorization of elective, direct, ancillary, urgent ... Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work ...
OR · Remote
$37K - $43K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
OR · Remote
$37K - $43K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
$99K - $135K/yr
Psychiatric Physician Assistant - Behavioral Health (Remote, Outpatient) Baylor Scott & White ... Participate in case reviews, clinical rounds, and quality improvement initiatives. * Support the ...
$99K - $135K/yr
Psychiatric Physician Assistant - Behavioral Health (Remote, Outpatient) Baylor Scott & White ... Participate in case reviews, clinical rounds, and quality improvement initiatives. * Support the ...
Grants Pass, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
Grants Pass, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Medford, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
Medford, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Newberg, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
Quick apply
Newberg, OR · Remote
$55K - $67K/yr
Our mission is to connect the world to life-saving behavioral health treatment. We deliver ... Interface with Admissions, Verification of Benefits, Utilization Review, and Clinical teams in ...
A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.
To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.
In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.
