Remote Utilization Review Professional

We are seeking a Full-time Utilization Review Professional, RN or Mental Health Clinician.
Strong knowledge base surrounding ASAM, substance abuse and mental health conditions, and Treatment is preferred.
Adolescent experience, CALOCUS/CASII receives special consideration.
Interested New Grad nurses, social workers, and/ or?counselors with strong capacity to learn this field are encouraged to apply.
Purpose of Position The role of the Utilization Review Professional?is to obtain insurance authorization for client care and treatment.
Responsibilities Perform utilization review functions including, but not limited to obtaining pre-authorizations, obtaining client updates, performing concurrent reviews and reporting discharge status.
Maintain accurate and timely documentation in accordance with policy and procedure.
Develop collaborative partnership relationships with insurance care managers through frequent communication and interaction in order to provide clients with expeditious delivery of services.
Develop collaborative partnership relationships with health care providers and support staff through frequent communication and interaction.
Function as a member of the Utilization Review Team to ensure that all daily responsibilities are met.
Respond to insurance denials through the appeals process when appropriate.
File retrospective reviews as needed.
Participate in continuing professional education.
Perform other duties as assigned or required.