Utilization Review Clinician
4 days 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.
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
*Will need GA & NC Clinical License.*
*Schedule Saturday - Tuesday 3rd shift 4/10's)*
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.
-
Clinical Mental Health Clinician
1 month ago
Greensboro, United States Hearts 2 Hands Counseling Group Part time $30 - $42Mental Health Clinician (PT, Contract, FT)We are seeking a Master's Level Contract Licensed Behavioral Health Clinician to serve Guilford, Rockingham, Randolph. Davidson, & Forsyth NC counties.Responsibilities:Clinicians function as multi-disciplinary team members to assist clients to reach their full potential. Clinicians utilize evidence-based treatments...
-
Underground Utility Estimator
4 weeks ago
Greensboro, United States JGR Development Group Full timeJob DescriptionJob DescriptionThe Utility Estimator will be responsible for preparing cost estimates for commercial, residential, and highway construction projects, or services to aid management in bidding on or determining price of utilities, take-offs, evaluate vendor quotes, change orders and contract updates.Duties and Responsibilities:• Consult with...
-
Clinic Med Lab Technologist
1 month ago
Greensboro, United States Cone Health Full timeOverview This position is primarily responsible for the analysis of human samples of blood, tissue and body fluids to determine chemical content, cell count, drug levels or blood type; may also search for specific microorganisms like bacteria or parasites; includes but is not limited to the preparation of the samples for examination, using automated...
-
Travel Ultrasound
3 weeks ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified Ultrasound in WINSTON-SALEM, North Carolina, 27103!Pay Information$1,972 per weekAbout The PositionID: 49528772 Shift: Day 5x8-Hour (07:45 - 17:00) Description: REQUIRED SKILLS / CERTS / Years of Experience: 1 yearTraveler Experience: Clinic WILL ACCEPT 1st Time TravelersLocals...
-
Travel Ultrasound
4 weeks ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified Ultrasound in WINSTON-SALEM, North Carolina, 27103!Pay Information$2,034 per weekAbout The PositionID: 49528772 Shift: Day 5x8-Hour (07:45 - 17:00) Description: REQUIRED SKILLS / CERTS / Years of Experience: 1 yearTraveler Experience: Clinic WILL ACCEPT 1st Time TravelersLocals...
-
Travel RRT
6 hours ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified RRT in Charlotte, North Carolina, 28204!Pay Information$1,845 per weekAbout The PositionID: 50080952 Shift: Night 3x12-Hour (18:45 - 07:15) Description: REQUIRED SKILLS / CERTS / Years of Experience: 2 Years' Minimum ExperienceTraveler Experience: Unit Will Accept 1st Time...
-
Greensboro, United States UnitedHealth Group Inc. Full timeAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start...
-
Travel CT Tech
4 weeks ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified CT Tech in Winston Salem, North Carolina, 27103!Pay Information$1,981 per weekAbout The PositionID: 49714822 Shift: Day 3x12-Hour (08:30 - 21:00) Description: REQUIRED SKILLS / CERTS / Years of Experience: 5 years of experience required depending on trauma experience.Traveler...
-
Travel CT Tech
2 weeks ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified CT Tech in Charlotte, North Carolina, 28204!Pay Information$2,007 per weekAbout The PositionID: 49304904 Shift: Night 3x12-Hour (19:45 - 08:15) Description: ***BLACK OUT DATES, July 4 Holiday; 07/04 - 07/07***REQUIRED SKILLS / CERTS / Years of Experience: 1 Year ExperienceTraveler...
-
Travel CT Tech
1 month ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified CT Tech in Charlotte, North Carolina, 28204!Pay Information$2,007 per weekAbout The PositionID: 49304904 Shift: Night 3x12-Hour (19:45 - 08:15) Description: ***BLACK OUT DATES, July 4 Holiday; 07/04 - 07/07***REQUIRED SKILLS / CERTS / Years of Experience: 1 Year ExperienceTraveler...
-
Travel CT Tech
3 weeks ago
Greensboro, United States AlliedTravelCareers Full timeAlliedTravelCareers is working with Infojini Healthcare to find a qualified CT Tech in Winston Salem, North Carolina, 27103!Pay Information$2,192 per weekAbout The PositionID: 49784455 Shift: Night 4x10-Hour (20:00 - 06:30) Description: REQUIRED SKILLS / CERTS / Years of Experience: 5 years of experience required depending on trauma experience.Traveler...
-
Psychiatric Nurse Practitioner
4 weeks ago
Greensboro, United States CBT Counseling Full timePsychiatric Nurse Practitioner - PMHNPWe don't just have a mission statement...we have a mission.At Cognitive-Behavioral Therapy Counseling Centers, our commitment to optimal mental health and steadfast support isn’t just for our clients; it extends to every team member.CBT Counseling Centers realizes the strength of our practice is our exceptional staff....
-
Psychiatric Nurse Practitioner
1 month ago
Greensboro, United States CBT Counseling Full timeJob DescriptionJob DescriptionPsychiatric Nurse Practitioner - PMHNPWe don't just have a mission statement...we have a mission.At Cognitive-Behavioral Therapy Counseling Centers, our commitment to optimal mental health and steadfast support isn’t just for our clients; it extends to every team member.CBT Counseling Centers realizes the strength of our...
-
RN Patient Care Manager
2 weeks ago
Greensboro, North Carolina, United States LHC Group Full timeWe are hiring an RN Patient Care Manager with Home Health experience. At SunCrest Home Health - Greensboro, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve—it truly is all about helping people....
-
RN Patient Care Manager
2 months ago
Greensboro, United States LHC Group Full timeWe are hiring an RN Patient Care Manager with Home Health experience. At SunCrest Home Health - Greensboro, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve—it truly is all about helping...
-
Clinical Pharmacist
1 month ago
Greensboro, United States Cone Health Full timeOverview This position is accountable for the management of all aspects of medication administration inclusive of the following processes:* Efficiency and effectiveness of medication therapeutics and dispensing* Evaluation of appropriateness of drug utilization* Evaluation of drug therapy and preprinted order sheets in individualizing therapy for patient...
-
Supervisor Cardiac Cath Lab
1 month ago
Greensboro, United States Cone Health Full timeOverview Talent Pool:nursingThis position is accountable for directing and providing leadership to designated areas in the Heart Center and Vascular Institute. This includes clinical and operational responsibility for the Cardiac Catheterization Lab, Electrophysiology Lab, Cath Holding Room, and Peripheral Vascular Lab. This position will function as both a...
-
Manufacturing Team Leader
1 month ago
Greensboro, United States VetJobs Full timeJob Description ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set,...
-
RN Patient Care Manager
1 month ago
Greensboro, United States LHC New Full timeSummaryWe are hiring an RN Patient Care Manager with Home Health experience.At SunCrest Home Health - Greensboro, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve-it truly is all about helping...
-
RN Patient Care Manager
2 weeks ago
Greensboro, United States LHC New Full timeSummaryWe are hiring an RN Patient Care Manager with Home Health experience.At SunCrest Home Health - Greensboro, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve-it truly is all about helping...