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Remote Behavioral Health Utilization Review Jobs in Washington

Centerbrite

BCBA (Part-time)

Fairfax, VA · On-site +1

$80 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $80-110/hr Flexible Schedule Hybrid (Remote ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

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Remote Behavioral Health Utilization Review information

What is a remote behavioral health utilization review?

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.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

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.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

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.

What are the most commonly searched types of Behavioral Health Utilization Review jobs in Washington?

The most popular types of Behavioral Health Utilization Review jobs in Washington are:

What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Washington?

For Remote Behavioral Health Utilization Review jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Remote Behavioral Health Utilization Review jobs in Washington look for?

The top searched job categories for Remote Behavioral Health Utilization Review jobs in Washington are:

What cities in Washington are hiring for Remote Behavioral Health Utilization Review jobs?

Cities in Washington with the most Remote Behavioral Health Utilization Review job openings:

Remote Behavioral Health Utilization Review jobs near you
Infographic showing various Remote Behavioral Health Utilization Review job openings in Washington as of August 2026, with employment types broken down into 2% As Needed, 82% Full Time, 14% Part Time, and 2% Contract. Highlights an 100% Remote job distribution.

PEER REVIEWER - OTOLARYNGOLOGY - REMOTE

iMPROve Health

Washington, DC • Remote

Contractor

Posted 21 days ago

Job description

iMPROve Health is seeking a Otolaryngology Physician to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis.  As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type.

BENEFITS:

  • Make a Difference: Use your clinical knowledge to improve the quality of care patients receive.
  • Professional Recognition: Join a network of highly respected experts in your specialty.
  • Competitive Compensation: Receive fair pay for your time and expertise.
  • Protect Standards of Care: Help uphold the integrity of your profession.
  • Work Remotely: Review cases from the convenience of your home or office.

DUTIES AND RESPONSIBILITIES:

  • Conduct objective, evidence-based peer reviews of clinical cases.
  • Make final determinations regarding medical necessity and quality of care.
  • Ensure decisions are fair, unbiased, and aligned with current standards of practice.
  • Submit reviews in a timely and professional manner using the IT systems provided.

QUALIFICATIONS:

  • Medical License: Must hold an unrestricted medical license in any U.S. state.
  • Board Certification: Required (if applicable), through a board recognized by:
    • The American Board of Medical Specialties (ABMS),
    • The American Osteopathic Association (AOA), or
    • Another nationally recognized board granting certification.
  • Clinical Experience:
    • Have at least five (5) years full-time equivalent experience providing direct clinical care to patients.
    • Have experience providing direct clinical care to patients within the past three (3) years.
    • Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review.
    • Have the clinical expertise to manage the medical or behavioral health condition or disease under review.
    • Must be actively engaged in direct or virtual patient care for at least 20 hours per week. Administrative work does not qualify.

TECHNOLOGY REQUIREMENTS:

  • Reliable Wi-Fi access.
  • Proficiency with Microsoft Word.
  • Access to a computer compatible with iMPROve Health’s IT systems.

OTHER REQUIREMENTS:

  • Must complete the electronic credentialing application and receive organizational approval prior to performing a case review.
  • Must complete a conflict of interest attestation upon credentialing and prior to performing a case review.
  • Active hospital medical staff privileges may be required, as applicable.
  • Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status.
  • Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews.

EOE/VET/Disability