Behavioral Health Nurse Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Behavioral Health (Remote).

Key Responsibilities

• Evaluate inpatient and outpatient services requiring precertification using evidence-based clinical criteria specific to Behavioral Health
• Conduct clinical reviews and collaborate with healthcare providers to gather necessary information
• Authorize services based on established guidelines or escalate to Medical Directors as needed

Required Qualifications

• Active, unrestricted RN license with multistate/compact licensure privileges
• Minimum 5 years of relevant Nursing experience
• Minimum 3 years of clinical experience in Behavioral Health or substance abuse
• At least 1 year of Utilization Management experience in concurrent review or prior authorization
• Commitment to attend a mandatory 3-week training with 100% participation