✨ About The Role
- The position involves utilizing clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program
- Requires applying critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions
- Responsibilities include coordinating, monitoring, and evaluating options to facilitate appropriate healthcare services/benefits for members
- Involves providing triage and crisis support, as well as identifying members at risk for poor outcomes and facilitating referral opportunities
- The role also includes promoting quality effectiveness of healthcare services and benefit utilization
âš¡ Requirements
- Registered Nurse (RN) with psychiatric specialty, certification, or experience
- Must have 3+ years of clinical practice experience in a psychiatric hospital, residential, or behavioral health treatment setting
- Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment
- Proficiency with computer skills including navigating multiple systems and keyboarding
- Experience in managed care/utilization review is preferred