Utilization Management Behavioral Health Nurse 2

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Description

The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Required Qualifications


Minimum of Associate's Degree in Nursing
Registered nurse with Compact Licensure (licensed and located in compact state)
Minimum of three (3) years of post-degree clinical experience in direct patient care
Three (3) years or more of Behavioral Health experience
Minimum of two (2) years of Behavioral Health utilization management experience, performing medical necessity reviews against criteria such as MCG, ASAM, Interqual, etc.
One (1) year of managed care experience working directly with insurance companies
Proficiency with Microsoft Office products: Word, Excel and MS Teams and OneNote
Adept experience working with computer


NOTE: Our department is available Monday - Friday from 7-6:30pm CST . Hours for this role are based on business need between that timeframe.

Work-At-Home Requirements


WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Preferred Qualifications


BSN degree
Master's degree in nursing
Use of EMR systems
Additional Non-compact nursing licenses
Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish


Scheduled Weekly Hours

40

Company info

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