Utilization Management Nurse Consultant – Behavioral Health - Remote

Overview

The Utilization Management Nurse Consultant is responsible for evaluating inpatient and outpatient services in Behavioral Health and Substance Abuse, ensuring high-quality healthcare through critical thinking and collaboration with healthcare providers.

In Short

• 100% remote position available in the U.S.
• Conduct clinical reviews via phone and electronic documentation.
• Apply evidence-based clinical criteria for service authorization.
• Collaborate with healthcare providers to gather necessary information.
• Thrive in a fast-paced, high-volume environment.
• Participate in on-call rotations including weekends and holidays.
• Requires active, unrestricted RN license.
• Minimum 5 years of relevant nursing experience required.
• Comprehensive benefits package offered.
• Training requirement of 3 weeks with 100% participation.

Requirements

• Active RN license with multistate/compact privileges.
• 5 years of nursing experience, with 3 years in Behavioral Health/Substance Abuse.
• 1 year of Utilization Management experience.
• Strong decision-making skills and clinical judgment.
• Proficient in clinical documentation tools and digital platforms.

Benefits

• Affordable medical plan options.
• 401(k) plan with matching contributions.
• No-cost wellness programs.
• Flexible work schedules and paid time off.
• Tuition assistance and financial coaching.