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We are searching for a Utilization Review Manager to work in a triage role for a highly regarded behavioral health plan. This is a REMOTE work-from-home role, with a regular M-F schedule, full time, permanent with benefits.
Requirements for the Utilization Review Manager:
  • Bachelor’s or Associates + California RN — OR Master’s degree with either: LCSW, LMFT, LPCC. All candidates must have active California licensure.
  • 2+ years experience in behavioral health or psychiatric healthcare
The Utilization Review Manager will:
  • Provide telephone triage on a queue, managing crisis intervention and emergency authorizations.
  • Manage authorizations for services creating provider lists to send out to members to help locate providers
  • In collaboration with clinical team, authorize and review UM of mental health and substance abuse services provided both inpatient and outpatient settings.
  • Collect and analyze UM data.

Occupational Category: 29-1140 Registered Nurses

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Application Instructions: Please apply using the form or send your resume to Debbie Winkelbauer.