FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Utilization Review Clinician – Behavioral Health
Centene Corporation. Perform clinical reviews and assess care related to mental health and substance abuse .
Posted 9/24/2026full-timeRemote • Kentucky • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical reviews and assessments related to mental health and substance abuse, with a strong focus on prior authorization and concurrent reviews. Engages effectively with providers and leadership to enhance care quality and compliance with regulatory guidelines.
Highest-signal resume keywords
Clinical Review ExpertiseBehavioral Health Utilization ReviewLCSW, LMHC, LPC, LMFT, LMHP, RN LicensureTreatment Plan AssessmentData Analysis for Quality Improvement
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical ReviewPrior Authorization ReviewConcurrent ReviewTreatment Plan AssessmentBehavioral Health Data Analysis
Soft Skills
Provider EducationInterpersonal CommunicationCollaboration with Healthcare Teams
Certifications & Qualifications
State LicensureMaster’s Degree in Behavioral Health
Industry Keywords
Mental HealthSubstance AbuseUtilization ReviewCare Quality ImprovementRegulatory Compliance
About the role
Key responsibilities & impact- Perform clinical reviews and assess care related to mental health and substance abuse
- Monitor and determine whether levels of care and services are medically appropriate
- Evaluate member treatment before, during, and after services
- Perform prior authorization reviews according to regulatory guidelines and criteria
- Perform concurrent reviews of behavioral health inpatient care, including treatment needs and discharge planning
- Analyze behavioral health member data to improve quality and utilization
- Educate providers, members, and families about the behavioral health utilization process
- Interact with behavioral health providers regarding levels of care and services
- Engage medical directors and leadership to improve care quality and efficiency
- Formulate and present cases in staffing and integrated rounds
- Comply with policies and standards and perform other assigned duties
Requirements
What you’ll need- Graduate of an Accredited School Nursing or Bachelor's degree and 2–4 years of related experience
- License to practice independently and/or state-required licensure
- Master’s degree for behavioral health clinicians required
- LCSW, LMHC, LPC, LMFT, LMHP, or RN state/compact state licensure required
- Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred
- Knowledge of mental health and substance abuse utilization review process preferred
- Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred
- Open to applicants in eastern, central, or mountain time zone, United States
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation