Centene Corporation
10,000+ employees
Founded 1984
🛡️ Insurance
💼 Consulting
🏥 Healthcare
Insurance • Consulting • Healthcare
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
Utilization Review Clinician – Behavioral Health
🕒 September 16
Where this job comes from
Posted on Centene Corporation's careers page, not through a job board
First seen by Remote Rocketship September 16
Still open on Centene Corporation's site. Checked 7 hours ago.
Centene Corporation
10,000+ employees
Founded 1984
🛡️ Insurance
💼 Consulting
🏥 Healthcare
Insurance • Consulting • Healthcare
Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.
📋 Description
• 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
• 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
• 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
Apply Now📊 Check your resume score for this job
Improve your chances of getting an interview by checking your resume score before you apply.
Similar Jobs
🕒 September 14
Pennsylvania telehealth clinician providing evidence-based counseling for Thriveworks’ mental health clients. Treating depression, anxiety, couples, and children through remote sessions.
🕒 September 9
Clinician Scientist defining and evaluating clinical intelligence for UpDoc’s physician-supervised AI chronic disease platform. Translating clinical reasoning into safe, testable product behavior.
🕒 September 4
Licensed mental health clinician delivering telehealth behavioral assessments, diagnoses, interventions, and care transitions. Supporting patients remotely across priority U.S. states.
🕒 August 19
Nurse Practitioner conducting Good Faith exams and aesthetic evaluations for a personalized wellness company. Creating treatment plans, prescribing medications, and maintaining patient safety and records.
🕒 August 17
Clinician Experience Specialist coordinating onboarding, schedules, payroll, and relationships for SCP Health’s U.S. anesthesia care teams. Maintaining coverage and clinician data remotely.
