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Weekend Therapy Clinical Reviewer Jobs (NOW HIRING)

Oak St. Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

Oak St. Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

Oak St. Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

Oak St. Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

Oak St. Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

CVS Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

CVS Health

Prior Authorization Clinical Reviewer

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

CVS Health Corporation

$26.01 - $74.78/hr

... review of physical and behavioral health related services. * Utilization of clinical skills to ... Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends ...

New

Self Medical Group

$47K - $66K/yr

Therapy Clinical Service Manager - Outpatient Job Category : Professional Requisition Number ... For further information, please review the Know Your Rights notice from the Department of Labor. #J ...

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Weekend Therapy Clinical Reviewer information

What is a weekend therapy clinical reviewer?

A Weekend Therapy Clinical Reviewer is a licensed mental health professional who evaluates clinical documentation and treatment plans over weekends to ensure patients are receiving appropriate care. They review cases for medical necessity, compliance, and adherence to established guidelines, often for insurance companies or healthcare organizations. Their assessments help determine if continued therapy services are justified, supporting quality care while managing costs.

What are the key skills and qualifications needed to thrive as a weekend therapy clinical reviewer?

To thrive as a Weekend Therapy Clinical Reviewer, you typically need a valid clinical license (such as RN, LCSW, LPC, or LMFT), strong clinical assessment abilities, and a solid understanding of behavioral health guidelines. Familiarity with utilization review software, electronic medical records (EMRs), and knowledge of insurance authorization processes are essential. Excellent communication, attention to detail, and sound judgment are crucial soft skills for effectively reviewing cases and collaborating with providers. These competencies ensure accurate, timely clinical reviews that support patient care and compliance with regulatory standards, especially during off-peak hours.

What are some common challenges faced by weekend therapy clinical reviewers and how can they be managed?

Weekend Therapy Clinical Reviewers often navigate fast-paced decision-making, especially when handling urgent cases or high volumes of clinical documentation within tight deadlines. Balancing thorough case review with efficient turnaround is key, as is maintaining clear communication with therapy providers who may also work non-traditional hours. To manage these challenges, reviewers can stay organized with structured workflows, utilize digital tools for documentation, and proactively clarify questions with supervisors or team members. Being adaptable and staying current with clinical guidelines also supports accuracy and confidence in recommendations.

What is the difference between Weekend Therapy Clinical Reviewer vs Weekend Therapy Case Manager?

AspectWeekend Therapy Clinical ReviewerWeekend Therapy Case Manager
CredentialsLicensed therapist or clinician, often with clinical certificationsLicensed social worker or counselor, with case management certification
Work EnvironmentReviewing clinical documentation, assessing treatment plansCoordinating patient care, managing cases, communicating with providers
Employer & IndustryHealthcare providers, mental health clinics, insurance companiesHealthcare organizations, mental health agencies, insurance companies

The Weekend Therapy Clinical Reviewer primarily evaluates clinical documentation and treatment plans, focusing on quality and compliance. In contrast, the Weekend Therapy Case Manager manages patient cases, coordinates care, and ensures service delivery. Both roles require relevant licensure and work within healthcare or mental health settings, but their core responsibilities differ significantly.

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Weekend Therapy Clinical Reviewer jobs near you
Infographic showing various Weekend Therapy Clinical Reviewer job openings in the United States as of September 2026, with employment types broken down into 3% As Needed, 73% Full Time, 16% Part Time, and 8% Contract. Highlights an 84% Physical, 1% Hybrid, and 15% Remote job distribution.

Prior Authorization Clinical Reviewer

Remote

Oak St. Health
Health Care and Social Assistance • 51 - 200 employees
Learn more about Oak St. Healthexternal

$26.01 - $74.78/hr

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Oak Street Health rating

7.1

Company rating: 7.1 out of 10

Based on 93 frontline employees who took The Breakroom Quiz

Job description

Mercy Care Prior Authorization Reviewer

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Mercy Care is a not-for-profit Medicaid managed-care health plan, serving Arizonans since 1985. We provide access to physical and behavioral health care services, to people who are eligible for Medicaid. Our members include families, children, seniors, and individuals who have developmental/cognitive disabilities. We hold multiple contracts with AHCCCS, Arizona's Medicaid agency, and deliver services throughout the state.

Mercy Care is administered by Aetna, a CVS Health company. Our staff is employed by Aetna and CVS Health. This gives Mercy Care the resources of a national organization, and still allows us to bring our members the familiarity and presence of a local team of people who put our members at the center of everything we do.

This position involves:

  • Prior authorization review of physical and behavioral health related services.
  • Utilization of clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program.
  • Application of critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for members with disabilities and special healthcare needs.
  • Taking provider calls related to prior authorization questions and making calls to members to inform of the coverage determination.
  • Gathering clinical information and applying appropriate medical necessity criteria/guideline, policy, procedure, and clinical judgment, in order to render coverage determination/recommendation/discharge planning along the continuum of care.
  • Utilization of clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members.
  • Identification of members who may benefit from care management programs and facilitation of the referral.
  • Identification of opportunities to promote quality effectiveness of healthcare services and benefit utilization.
  • Sedentary work involving periods of sitting, talking, and listening.
  • Performing other duties as assigned.

Required Qualifications:

  • 5+ years of clinical experience as RN (Registered Nurse).
  • Ability to work 8-hour shifts, 5-days per week, with rotating days (including some weekends & holidays), supporting Arizona Time Zone.
  • Must have an active and unrestricted RN licensure in the state of Arizona or Compact RN licensure.

Preferred Qualifications:

  • Previous experience in utilization management.
  • Previous experience in both medical and behavioral health fields.
  • Previous experience in acute care.
  • Strong critical thinking and written communication skills.
  • Ability to operate independently.

Education:

  • Associate's degree in Nursing.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $26.01 - $74.78

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

What Oak Street Health employees say

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About Oak Street Health

Sourced by ZipRecruiter

Oak Street Health is a rapidly growing company of primary care centers for adults on Medicare in medically-underserved communities where there is little to no quality healthcare. Oak Street's care is based on an entirely new model that is based on value for its patients, not on volume of services. The company is accountable for its patients' health, spending more than twice as long with its patients and taking on the risks and costs of their care.

Industry

Health care and social assistance

Company size

51 - 200 Employees

Headquarters location

Chicago, IL, US

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