UM RN - Behavioral Health

Responsibilities:

• Perform prospective, concurrent, and retrospective utilization reviews for inpatient, outpatient, ambulatory, and ancillary behavioral health services.
• Assess medical necessity using established clinical criteria and collaborate with providers on treatment options.
• Develop discharge plans and coordinate care across the healthcare continuum.

Requirements:

• Current unrestricted RN license with at least 2 years acute clinical nursing and 1 year behavioral health experience.
• Strong knowledge of medical necessity criteria, clinical guidelines, and managed care processes.
• Excellent communication, problem-solving, and Microsoft Office skills; ability to work across time zones.

Benefits:

• Competitive annual salary range of $65,000 - $85,000 with full-time remote flexibility.
• Opportunity to apply clinical expertise while improving healthcare access and outcomes.
• Supportive environment with potential for certification advancement and career development.