Utilization Review Clinician – Behavioral Health

Centene Corporation

. Perform clinical reviews and assess care related to mental health and substance abuse .

Posted 9/16/2026full-timeRemote • Louisiana • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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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

Active Louisiana LicenseMaster’s Degree for Behavioral Health CliniciansLCSW, LMHC, LPC, LMFT, LMHP, or RN LicensureClinical Knowledge in Mental Health and Substance AbuseExperience in Utilization Review Process

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical ReviewPrior Authorization ReviewConcurrent ReviewTreatment Plan AssessmentBehavioral Health Data Analysis

Soft Skills

Provider EducationInterpersonal CommunicationCollaboration with Healthcare Teams

Certifications & Qualifications

LCSWLMHCLPCLMFTLMHPRN Licensure

Industry Keywords

Mental HealthSubstance AbuseUtilization ReviewBehavioral HealthDischarge Planning

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 in accordance with 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 with medical directors and leadership to improve care quality and efficiency
Formulate and present cases in staffing and integrated rounds
Comply with all policies and standards
Perform other duties as assigned

Requirements

What you’ll need

Candidates must reside in Louisiana
Active, unrestricted Louisiana license required
Must consistently work either Sunday through Thursday or Tuesday through Saturday, 8:00 AM to 5:00 PM CST
Graduate of an Accredited School Nursing or Bachelor's degree
2–4 years of related experience
License to practice independently and/or state-required licensure
Master’s degree for behavioral health clinicians required
One of the following required licenses/certifications: LCSW, LMHC, LPC, LMFT, LMHP, or RN with state and/or compact state licensure
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

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
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