Behavioral Health Utilization Review RN

A company is looking for a Behavioral Health Utilization Review RN for a full-time remote position.

Key Responsibilities

Review and evaluate electronic medical records for emergency admissions and assess medical necessity

Apply clinical guidelines to ensure proper utilization of healthcare resources and participate in discussions with physicians

Enter clinical review information for insurance authorization and analyze utilization patterns and trends

Required Qualifications

Current and unrestricted RN license

Behavioral Health Acute Care Experience

At least 3 years of clinical experience in an acute care setting

At least 2 years of utilization management experience in acute admission and concurrent reviews

Intermediate experience with InterQual and / or MCG criteria within the last two years