Job Summary
A health insurance provider has an open position for a Remote Utilization Management Clinician.
Must be able to:
- Provide first level clinical review for all mental health, behavioral health and substance abuse authorization requests
- Act as a member advocate by expediting the care process through the continuum, working in concert with the health care delivery team
- Screen and coordinate cases within the utilization management department
Qualifications for this position include:
- Graduate of Nursing program required
- Experience working with behavioral health cases
- 3+ years of utilization management/quality improvement experience on the Payer side
- Working knowledge and understanding of basic utilization management concepts
