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Utilization Review Clinician - Behavioral Health

Oklahoma Staffing
Full-time
On-site
Oklahoma City, Oklahoma, United States

Clinical Professional Opportunity

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. Location: Oklahoma (Residency Required) Work Schedule: TuesdaySaturday 8am-5pm Training Schedule: MonFri, 8am5pm (56 weeks)

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.

Responsibilities include:

  • Apply medical necessity criteria to determine appropriate care levels.
  • Support children in foster/adoptive care and adult behavioral health members.
  • Review both inpatient and outpatient cases.
  • Provide comprehensive behavioral health and substance use support.
  • Participate in holiday rotation.
  • Active Oklahoma license: LPC, LMFT, LCSW, or RN.

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 For Fidelis Care only: LMSW, LCSW, LMHC, LPC, LMFT, LMHP or RN required

Pay Range: $26.50 - $47.59 per hour 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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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