Our Healthcare Insurance client is seeking a Behavioral Health Utilization Management Nurse to join their team for a contract role!
Our client has over 5,000 employees and is the number 1 health insurer in the state of North Carolina, serving more than 3.89 million customers. Health care is changing, and our client is leading the way by providing innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. Our client is a not-for-profit with headquarters in Durham, NC.
Position: Behavioral Health Utilization Management Nurse
Term: 3+ Months
Location: State of NC preferred, or the following states: South Carolina, Georgia, Florida, Maryland, Pennsylvania, and Virginia.
Hours: 8am -5pm Monday through Friday. Work every 3rd weekend 8am-3pm on Sat and 8am-12pm on Sunday; comp time is given back during the week so no overtime is required
- RN preferred, LPNs considered.
- Must have Licensure in one of the states listed
- Behavioral Health Experience and Behavioral Health UM (Utilization Management) experience is most important - just having BH clinical is NOT ideal
- Utilization Management (UM) experience
The Behavioral Health UM Nurse/Episodic Care Manager is responsible for performing medical reviews to assess, facilitate, and coordinate the delivery of care across the Health Care System. The Behavioral Health UM Nurse/Episodic Care Manager acts as a member advocate to promote and coordinate the delivery of quality, cost effective health care services based on medical necessity and contractual benefits. In addition, the Behavioral Health UM Nurse/Episodic Care Manager coordinates with providers and consumers to support the delivery of high quality care across the health care system.
****To be eligible to contract at this client you must be able to pass a drug test and criminal background check.