Multi-State Licensed RN Reviewer

Job Summary

A company is looking for a Clinical Care Reviewer II - Multi State License - RN - Behavioral Health.

Key Responsibilities

• Complete medical necessity reviews for behavioral health services
• Coordinate care and engage with collaborative partners for appropriate transitions
• Maintain knowledge of regulations and assist with quality improvement initiatives

Required Qualifications, Training, and Education

• Associates of Science (A.S) in Nursing or Bachelor of Science (B.S) in Social Work required
• Three (3) years of clinical experience required
• Utilization Management/Utilization Review experience preferred
• Medicaid/Medicare/Commercial experience preferred
• Current, unrestricted RN Licensure or Licensed Social Worker (LSW) required