Why this grade
This listing scored 76/100, which is a B. It lost the most ground on remote clarity.
- Pay transparency 25 / 25 A published salary range, worth more than any other single factor because it is what a candidate cannot find out without applying.
- Description depth 20 / 20 How much the posting actually says about the work, measured in characters of real text.
- Freshness 12 / 15 How recently it was posted. Older postings are likelier to be filled or abandoned.
- Remote clarity 8 / 15 Whether "remote" means anywhere, or is quietly restricted to one country.
- Role specificity 6 / 10 Whether the listing is tagged well enough to tell what the role actually is.
- Corroboration 5 / 10 Whether more than one source carries this listing.
Every figure above is arithmetic over the posting itself — its salary field, its text, its age, its tags and how many sources carry it. How the grades work →
Mid level Full Time
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.
Key Details: This is a remote position; however, applicants must hold an active Georgia Licensed Clinician or Compact Nursing License. Candidates must have experience in behavioral health. The ideal candidate is computer savvy, has provider-facing experience, demonstrates excellent communication and customer service skills, is highly organized, and can quickly adapt to change. The work schedule is Monday through Friday, 8:00 AM to 5:00 PM, with rotating holidays and weekends.
- 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:
- 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
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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
Originally posted on Himalayas
Apply for this role Opens himalayas.app — the link as listed; we have not yet verified it is the employer's own page
Where this listing came from
- 16 Sep 2026 Himalayas first sighting
Seen on 1 board over 0 days.