Behavioral Health Utilization Nurse

Company: VirtualVocations
Location: West Palm Beach
Posted on: April 5, 2025

Job Description:

A company is looking for a Utilization Management Nurse with a Behavioral Health focus (Remote).
Key Responsibilities

Review provider submissions for prior service authorizations, focusing on behavioral health
Evaluate requests for medical necessity and appropriate service levels
Collaborate with internal departments to ensure continuity of care and maintain productivity standards

Required Qualifications

Active, unrestricted RN, LPN, LCSW, or LPC license in any U.S. state
Completion of an accredited Registered Nursing program or equivalent experience
2 years of clinical experience, preferably in hospital nursing, utilization management, or case management
Understanding of state and federal healthcare regulations
Experience with InterQual and NCQA standards

Keywords: VirtualVocations, Miami , Behavioral Health Utilization Nurse, Healthcare , West Palm Beach, Florida

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