Centene Corporation • Fort Sam Houston, TX 78234 • Posted today
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The Utilization Review Clinician - Behavioral Health at Centene Corporation performs a clinical review and assesses care related to mental health and substance abuse. This role involves evaluating member's treatment, performing prior authorization reviews, concurrent review of behavioral health inpatient services, analyzing behavioral health member data to improve quality and utilization of services, and providing education to members, their families, and healthcare providers. The position requires collaboration with medical directors and leadership to enhance the quality and efficiency of care.
About Centene Corporation
Centene Corporation is a leading healthcare enterprise in the United States, specializing in managed healthcare products and services primarily through Medicaid, Medicare, and commercial products. They offer healthcare coverage through managed care plans that include medical, behavioral, and specialty services, aiming to improve health outcomes for underserved populations. Operating on a global scale, Centene has a significant presence in over 30 states and continues to grow through strategic expansions and partnerships, such as acquiring WellCare Health Plans in 2020.
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.
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.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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