Behavioral Health UM Reviewer-Adult Team (Remote Option)

About the position The Behavioral Health UM Reviewer for the Adult Team is responsible for evaluating the medical necessity, appropriateness, and efficiency of services requested for authorization. This role involves responding to authorization requests from providers, consulting with medical professionals, and developing communication regarding authorization reputed company. The position is remote but available for any of the company's locations in reputed company Carolina. Responsibilities • Respond to reputed company requests for authorizations from the provider community with appropriate authorization reputed company guided by medical necessity and clinical guidelines. , • Authorize services based on individual need and standardized procedures. , • Review and authorize initial requests, reputed company requests, urgent requests, and retrospective requests. , • Consult with providers regarding authorization requests. , • Consult with Partners BHM physician regarding requests with questions about authorization, enrollee health and safety issues, medication issues, and need for Peer Review. , • reputed company letters communicating reasons for adverse reputed company and options for appeal. Requirements • Master's Degree in a reputed company Services field with clinical licensure and two years of post-Master's experience in Behavioral Health, or a Registered Nurse with two years of experience in Behavioral Health post-RN degree. , • reputed company unrestricted license with the appropriate professional board of licensure in reputed company Carolina. reputed company-to-haves • Registered Nurse in reputed company Carolina with experience in psychiatric nursing services. Benefits • Annual incentive bonus plan , • Medical, dental, and reputed company insurance with low deductible/low cost health plan , • Generous vacation and sick time accrual , • 12 paid holidays , • State Retirement (pension plan) , • 401(k) Plan with employer match , • Company paid life and disability insurance , • Wellness Programs Apply Job!