Behavioral Health RN Review Nurse

Job Summary

A company is looking for a Preservice Review Nurse - Behavioral Health - Remote in PST or MT.

Key Responsibilities

• Perform clinical coverage review services, interpreting state and federal mandates and clinical information
• Collaborate with team members to meet individual and team performance metrics
• Engage in telephonic discussions with healthcare providers and members regarding benefit coverage determinations

Required Qualifications

• Current unrestricted RN license in the state of residency
• Professional experience in direct patient care
• Proven exemplary clinical documentation and critical thinking skills
• Demonstrated proficiency in computer skills, including Excel and clinical platforms
• Designated secure workspace with access to high-speed internet