Utilization Review Clinical Specialist - Behavioral Health (Remote)
📋 Role Overview & Responsibilities
Employer Industry: Healthcare Services
Why Consider This Job Opportunity
Competitive pay up to $80,000 per year Opportunity for career advancement and professional growth within the organization Comprehensive benefits package including health insurance and retirement plans Flexibility to work remotely Supportive and collaborative work environment Chance to make a positive impact on patient care and outcomes
What To Expect (Job Responsibilities)
Conduct initial clinical assessments and continued stay assessments using evidence-based criteria Collaborate with physicians to obtain necessary documentation to support medical necessity Document all actions and activities in the case management software system Coordinate Peer to Peer discussions for concurrent denials Communicate effectively with insurance providers and case managers for reviews and authorizations
What Is Required (Qualifications)
Associates Degree in Nursing At least 3 years of previous psych nursing experience Licensed Practical Nurse or Licensed Registered Nurse Data entry skills and proficiency in Google Docs, Google Sheets, and email applications Ability to prioritize assignments and demonstrate effective time-management skills
How To Stand Out (Preferred Qualifications)
3 plus years of Utilization review experience ACM or CCM Certification Basic knowledge of clinical and psychosocial aspects of patient care Detail-oriented, flexible, and committed to patient advocacy Excellent verbal and written communication skills
#HealthcareServices #PatientCare #UtilizationReview #RemoteWork #CareerGrowth
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