Current jobs related to Utilization Review Clinician - Austin - Centene Corporation
-
Utilization Review RN
2 days ago
Austin, TX, United States Ascension Seton Northwest Full timeUtilization Review RN Details * Department: Utilization Review * Schedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays required * Facility: Ascension Care Management Insurance Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including...
-
RN Mgr-Utilization Review
2 days ago
Austin, TX, United States Ascension Seton Northwest Full timeRN Mgr-Utilization Review Details * Department: Utilization Management * Schedule: FT - Days * Location: Remote after training Benefits 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 & adoption...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
RN-Utilization Review
4 weeks ago
Austin, TX, United States Ascension Seton Northwest Full timeRN-Utilization ReviewDetails * Department: UR Review * Schedule: FT - Days * Location: Austin, TX - Remote after 4 weeks of training onsite Benefits 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...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Clinical Utilization Review Nurse
5 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a skilled Clinical Utilization Review Nurse to join our team at Ascension Seton Northwest. As a Utilization Review Registered Nurse, you will play a critical role in ensuring the quality and efficiency of our healthcare services.Key ResponsibilitiesConduct thorough reviews of patient admissions and service requests to determine...
-
RN-Utilization Review
3 weeks ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits 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 & adoption assistance Tuition...
-
RN-Utilization Review
1 month ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits 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 & adoption assistance Tuition...
-
RN-Utilization Review
1 month ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits 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 & adoption assistance Tuition...
-
RN-Utilization Review
1 month ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits 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 & adoption assistance Tuition...
-
RN Mgr-Utilization Review
6 days ago
Austin, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT - DaysLocation: Remote after training Benefits 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 & adoption assistance Tuition reimbursement Ways...
-
Utilization Review RN
2 weeks ago
Austin, TX, United States Ascension Full timeDetails Department: Utilization Review Schedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays required Facility: Ascension Care Management Insurance Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ...
-
Senior Utilization Review Nurse
7 days ago
Austin, Texas, United States Texas Department of Aging & Disability Services Full timeJob Overview: Under the general oversight of the High Needs Quality Assurance Manager, the Senior Utilization Review Nurse is tasked with assessing long-term services and supports (LTSS) for individuals with significant needs enrolled in various programs, including: STAR Kids, STAR+PLUS, Home and Community-based Services (HCS), Texas Home Living (TxHmL),...
-
Healthcare Utilization Review Specialist
4 days ago
Austin, Texas, United States UHS Full timeJob SummaryThe Utilization Review Coordinator PRN is a key member of the Austin Oaks Hospital Team who is responsible for ensuring that financial benefits are maximized in the treatment and discharge planning for assigned cases through initial and continued stay reviews, prior authorization work for discharge services, effective liaison work and...
-
RN Manager
2 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a highly skilled and experienced RN Manager to lead our Utilization Review and Optimization team at Ascension Seton Northwest. As a key member of our clinical leadership team, you will be responsible for managing effective utilization review processes, collaborating with directors to develop quality review programs, and overseeing...
-
RN Mgr
3 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a skilled RN Utilization Review Manager to join our team at Ascension Seton Northwest. The successful candidate will be responsible for managing effective utilization review processes, including patient statusing and medical necessity review functions.Key ResponsibilitiesCollaborate with the director to develop and implement quality...
Utilization Review Clinician
1 month 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.
Must be licensed in either of the following states: TX, KS, WA, OK, LA
Behavioral experience required
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:
Centene 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.
