Nevada Licensed Utilization Manager

Job Summary

A company is looking for a Behavioral Health Care Review Clinician (RN- Utilization Manager) based in Nevada.

Key Responsibilities

• Assess services for members to ensure optimum outcomes and compliance with regulations
• Analyze clinical service requests against evidence-based clinical guidelines
• Conduct reviews for prior authorization and collaborate with multidisciplinary teams

Required Qualifications

• At least 2 years of MCG experience
• Behavioral Health Concurrent Review and Prior Authorization experience in an MCO setting
• Must obtain NV RN Licensure within 90 days of hire
• ASAM certification upon hire
• Remote work experience