We have other current jobs related to this field that you can find below
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RN Registered Nurse
1 day ago
Tulsa, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT, Monday-Friday, 8:30am-5:00pmHospital: Ascension St. John Medical CenterLocation: Tulsa, OKBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave...
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RN Registered Nurse
1 day ago
Tulsa, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT, Monday-Friday, 8:30am-5:00pmHospital: Ascension St. John Medical CenterLocation: Tulsa, OKBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave...
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RN Registered Nurse
1 day ago
Tulsa, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT, Monday-Friday, 8:30am-5:00pmHospital: Ascension St. John Medical CenterLocation: Tulsa, OKBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave...
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Travel Nurse RN
1 month ago
Tulsa, United States Medical Solutions Remote Work Freelance Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Travel We’re seeking talented healthcare professionals whose adventure...
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Travel Nurse RN
3 months ago
Tulsa, United States Medical Solutions Full timeJob DescriptionMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Travel We’re seeking talented healthcare professionals whose adventure...
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Travel Nurse RN
1 month ago
Tulsa, OK, United States Medical Solutions Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma. Shift: 8 hours, days ~ Employment Type: Travel We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Some of the industry-leading benefits enjoyed by Medical Solutions...
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Travel Nurse RN
1 month ago
Tulsa, OK, United States Medical Solutions Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma. Shift: 8 hours, days ~ Employment Type: Travel We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Some of the industry-leading benefits enjoyed by Medical Solutions...
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RN Registered Nurse
1 day ago
Tulsa, Oklahoma, 74104, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT, Monday-Friday, 8:30am-5:00pmHospital: Ascension St. John Medical CenterLocation: Tulsa, OKBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave...
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Travel Nurse RN
1 month ago
Tulsa, OK, United States Medical Solutions Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We’re seeking talented healthcare professionals whose adventure...
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Travel Nurse RN
1 month ago
Tulsa, OK, United States Medical Solutions Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We’re seeking talented healthcare professionals whose adventure...
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Travel Nurse RN
3 months ago
Tulsa, OK, United States Medical Solutions Full timeMedical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Travel We’re seeking talented healthcare professionals whose adventure...
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Material Review Engineer
4 weeks ago
Tulsa, United States Spirit AeroSystems Full timeOverviewSpirit AeroSystems designs and builds aerostructures for both commercial and defense customers. With headquarters in Wichita, Kansas, Spirit operates sites in the U.S., U.K., France and Malaysia. The company's core products include fuselages, pylons, nacelles and wing components for the world's premier aircraft. Spirit AeroSystems focuses on...
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Clinical Utilization Specialist
5 days ago
Tulsa, Oklahoma, United States CommunityCare Full timePOSITION OVERVIEW: Accountable for the clinical evaluation of utilization requests and the identification and execution of potential care coordination opportunities for the overall membership, institutionalized populations, high-risk individuals, and other members recognized with at-risk or high utilization requirements. Acts as an integral member of the...
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Medical Management
1 month ago
Tulsa, United States CommunityCare Full timeJOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Concurrent Review Team....
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Tulsa, United States Hanger Full timeWhy Us? With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics...
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Tulsa, United States Hanger Full timeWhy Us?: With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics...
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Tulsa, United States Hanger Full timeWhy Us? With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics...
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Utility Inspector
3 months ago
Tulsa, United States Tulsa Inspection Resources, LLC Full timeJob DescriptionJob DescriptionGENERAL SUMMARYRely on expertise, knowledge, and technical qualifications to interpret written industry and customer standards, specifications, regulations, and site restrictions. Recommend or initiate direct actions required to meet and comply with all requirements. Identify issues related to the progress and quality of work...
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Utility HDD/Trenchless Engineer
2 months ago
Tulsa, United States Mott MacDonald Full timeWe’re looking for an engineer with experience working on horizontal directional drilling design to join the Mott MacDonald team. As an HDD engineer your responsibilities will include: Carry out design tasks under the supervision of a senior engineer. Review geotechnical reports Develop geometry required for HDD plans and profiles Complete design...
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Clinical Director
4 weeks ago
Tulsa, United States LifeStance Health Full timeJob Description At LifeStance Health, we strive to help individuals, families, and communities with their mental health needs. Everywhere. Every day. It's a lofty goal; we know. But we make it happen with the best team in mental healthcare. Thank you for taking the time to explore a career with us. As the fastest growing mental health practice group in the...
Utilization Review Clinician
2 months ago
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
This is a remote position
Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.
Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate
Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria
Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
Analyzes BH member data to improve quality and appropriate utilization of services
Provides education to providers members and their families regrading BH utilization process
Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
Engages with medical directors and leadership to improve the quality and efficiency of care
Formulates and presents cases in staffing and integrated rounds
Performs other duties as assigned
Complies with all policies and standards
Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.
License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.
Master’s degree for behavioral health clinicians 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.
License/Certification:
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
Pay Range: $25.97 - $46.68 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
