UM RN - Behavioral Health

📋 Description

• Evaluate, coordinate, and manage behavioral health services using clinical expertise.
• Perform utilization reviews for inpatient, outpatient, ambulatory, and ancillary services.
• Assess medical necessity and levels of care using criteria and guidelines.
• Coordinate discharge planning and care across stakeholders.
• Support care plans and services across the healthcare continuum.
• Communicate with members, providers, and other stakeholders to facilitate planning.

🎯 Requirements

• Current unrestricted RN license.
• Minimum 2 years acute clinical nursing experience.
• At least 1 year of behavioral health clinical experience.
• Experience in managed care/utilization management preferred.
• Case management certification or progress toward certification preferred.
• Strong knowledge of medical necessity criteria and guidelines.

🎁 Benefits

• Salary: $65,000 - $85,000 per year, depending on qualifications.
• Full-time, permanent remote position.
• Opportunities to apply clinical expertise to improve access and outcomes.
• Supportive environment with growth and development opportunities.