Remote Health insurance Jobs in Lafayette, LA
Utilization Review Clinician - Behavioral Health
Centene CorporationLafayette, 825 Kaliste Saloom Rd, Ste 200, US
UNCAPPED COMMISSION No Experience Necessary Remote Insurance Sales Representative
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Dyal AgencyLafayette, LA, US
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Allstate Insurance CompanyLafayette, Louisiana, United States
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Brown & Brown InsuranceLA, US- Promoted
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SonderMindCarencro, WA, United States
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Global EliteLafayette, Louisiana, United States, 70501
Thriving Remote Insurance Agent Role
The Williams AgencyLafayette, LA, US
HOME BASED INSURANCE SALES
The Jernigan AgencyLafayette, LA, US
Utilization Behavioral Health Professional
HumanaWork at Home, Louisiana
URGENT OPENING || INSURANCE PROFESSIONAL || ENTIRELY REMOTE
Dilbert AgencyLafayette, LA, US
Remote Insurance Customer Service Representative (Unlicensed)
Mass MarketsLA, USUtilization Review Clinician - Behavioral Health
Centene CorporationLafayette, 825 Kaliste Saloom Rd, Ste 200, US- Full-time
- Remote
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 : Remote. Candidate must reside in Louisiana
Hours : Schedule will be Tuesday-Saturday
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 :
Location : Remote. Candidate must reside in Louisiana
Hours : Schedule will be Tuesday-Saturday
Pay Range : $25.97 - $46.68 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. Total compensation may also include additional forms of incentives.