Behavioral Health Utilization Review RNVirtualVocations • Fresno, California, United States
Behavioral Health Utilization Review RN
VirtualVocations • Fresno, California, United States
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A company is looking for a Behavioral Health Utilization Review RN for a full-time remote position.
Key Responsibilities
Review and evaluate electronic medical records for emergency admissions and assess medical necessity
Apply clinical guidelines to ensure proper utilization of healthcare resources and participate in discussions with physicians
Enter clinical review information for insurance authorization and analyze utilization patterns and trends
Required Qualifications
Current and unrestricted RN license
Behavioral Health Acute Care Experience
At least 3 years of clinical experience in an acute care setting
At least 2 years of utilization management experience in acute admission and concurrent reviews
Intermediate experience with InterQual and / or MCG criteria within the last two years
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