Referso Jobs

Clinical Review Nurse - Concurrent Review - J00933

IMCS Group Inc · Posted Nov 12, 2026

Open

Clayton, Missouri, United States
Full-time · Mid
2–4 years

Apply with Referso

Clinical Review Nurse - Concurrent Review - J00933

IMCS Group Inc · Posted Nov 12, 2026

Open

Clayton, Missouri, United States
Full-time · Mid
2–4 years

Apply with Referso

Case Manager - Outpatient Services

Acadia Healthcare · Posted Nov 11, 2026

Open

Danville, Pennsylvania, United States
3+ years

Apply with RefersoAI Apply on careers page

Case Manager to coordinate outpatient behavioral health services

Responsibilities

Assure that patients meet care criteria from admission through discharge
Initiate authorization with network providers
Maintain knowledge of clinical information for patient’s stay by review of documentation, participate in staffing, attend care conferences and collaborate with other members of the treatment team
Perform concurrent review with network providers; monitor medical record documentation using knowledge of established guidelines to promote compliance and further ensure quality for retrospective review by external review entities
Liaison with physician and other treatment team members to assure that all aspects of treatment are fully documented

Requirements

Bachelor’s degree in Social Work, Counseling or related human service field
Licensed health care professional with mental health experience (MSW; LCSW; RN; CNS; ARNP; Registered Mental Health Professional (MHP); Counselor (MA; MFT)

Skills

clinical documentation care coordination authorization with network providers

Utilization Review Clinician - Behavioral Health

Centene Corporation · Posted Nov 10, 2026

Open

Remote, United States
Remote
Full-time
$27–$49 per hour
2–4 years

Apply with RefersoAI Apply on careers page

Performs clinical review and utilization management for mental health and substance abuse services, ensuring medically appropriate care and compliance with regulatory guidelines.

Compensation

Pay Range: $27.02 - $48.55 per hour

Responsibilities

Evaluates member treatment for mental health and substance abuse
Performs prior authorization reviews
Conducts concurrent review of behavioral health inpatient care
Analyzes member data to improve quality and utilization
Provides education to providers, members and families

Requirements

Bachelor's degree
Master's degree
Nice to have: behavioral health clinician experience
Nice to have: knowledge of utilization review process
Nice to have: experience with providers and healthcare teams

Skills

clinical review utilization management prior authorization concurrent review data analysis

Utilization Review Manager

Avalon Health Care · Posted Nov 11, 2026

Open

Federal Way, Washington, United States +1 more
Full-time
$40–$45 per hour

Apply with RefersoAI Apply on careers page

Manage utilization review and authorizations to support appropriate admissions and revenue integrity in a skilled nursing setting.

Locations (2)

Federal Way, Washington, United States
Seattle, Washington, United States

Compensation

$40.00 - $45.00/hour

Responsibilities

Manage pre-admission authorizations, insurance verification, Single Case Agreements (SCAs), and Letters of Agreement (LOAs)
Conduct utilization review and level-of-care determinations to support appropriate admissions and continued stays
Perform concurrent reviews and obtain clinical updates from physicians, therapy teams, and interdisciplinary team members
Communicate resident progress, clinical status, and discharge plans to payers in a timely and accurate manner
Negotiate appropriate levels of care and reimbursement arrangements within payer contract requirements

Requirements

Healthcare - Care Review Clinician II

Saviance Technologies · Posted Nov 6, 2026

Open

Remote
Remote
2–4 years

Apply with RefersoAI Apply on careers page

Provides concurrent review and prior authorizations for Molina Healthcare members, ensuring appropriate utilization of inpatient and outpatient services.

Responsibilities

Conducts daily review and evaluation of members requiring hospitalization or procedures
Provides prior authorizations and concurrent reviews per Molina policy
Identifies appropriate benefits, eligibility, and expected length of stay
Participates in interdepartmental integration and collaboration
Maintains department productivity and quality measures

Requirements

Completion of an accredited Registered Nursing program
Nice to have: PEGA experience

Skills

Behavioral health/psychiatric reviews Utilization management Prior authorizations Concurrent review NCQA Interqual Microsoft Office

Clinical Review Nurse - Concurrent Review - J00933

Clinical Review Nurse - Concurrent Review - J00933

Responsibilities

Requirements

Skills

Case Manager - Outpatient Services

Responsibilities

Requirements

Skills

Utilization Review Clinician - Behavioral Health

Compensation

Responsibilities

Requirements

Skills

Utilization Review Manager

Locations (2)

Compensation

Responsibilities

Requirements

Healthcare - Care Review Clinician II

Responsibilities

Requirements

Skills

Benefits

Skills

Benefits

Concurrent review jobs

Responsibilities

Requirements

Skills

Responsibilities

Requirements

Skills

Compensation

Responsibilities

Requirements

Skills

Locations (2)

Compensation

Responsibilities

Requirements

Responsibilities

Requirements

Skills

Benefits

Skills

Benefits