Utilization Management Nurse – Behavioral Health Focus (remote) Category Location Phoenix, Az
Morgan Stephens
Phoenix, Az, USA
$40 ph
Remote
Behavioral health services
Managed care organization experience
Prior authorizations
Review provider-submitted service authorization requests and evaluate medical necessity, with a primary focus on behavioral health services
Job Summary
Review provider-submitted service authorization requests and evaluate medical necessity, with a primary focus on behavioral health services.
This position plays a key role in ensuring members receive appropriate and timely care by performing prior authorizations and concurrent reviews.
The role involves identifying appropriate benefits, determining eligibility and expected length of stay, and collaborating with internal departments for continuity of care.
Matching Summary
Review provider-submitted service authorization requests and evaluate medical necessity, with a primary focus on behavioral health services.
Salary
$40 per hour
Skills & Requirements
Must-have
Behavioral health services
Managed Care Organization experience
Prior authorizations
Concurrent reviews
Medical necessity evaluation
Nice-to-have
Continuity of care
Professional relationships
Team-oriented
Key Requirements
Active, unrestricted RN, LPN, LCSW, or LPC license
2 years of clinical experience
Completion of an accredited Registered Nursing program