Utilization Review Clinician - Behavioral Health
$56,202–$100,984 year
Remote · Georgia, United States or Ohio, United States
Job Summary
Utilization Review Clinician on Centene's Medical Management/Health Services team responsible for clinical review of mental health and substance abuse services, monitoring level of care, conducting prior authorization and concurrent reviews, providing education to providers and families, collaborating with medical directors, and supporting quality/utilization initiatives. Requires graduate degree entry (Master’s preferred for behavioral health clinicians) and relevant licensure; incumbents may work in remote/hybrid/office settings with weekend availability and must reside in EST or CST time zones.
Required Qualifications
- Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience
- Master’s degree for behavioral health clinicians required
- License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required
- LCSW- 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 - Registered Nurse - State Licensure and/or Compact State Licensure required
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