Impactful Utilization Review RN - Behavioral Health

Universal Hospital Services Inc.; Westwood (GA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Referral Bonus Program

Competitive Compensation

Generous Paid Time Off

Medical, Dental, Vision Plans

401(K) with company match

SoFi Student Loan Refinancing Program

Job summary

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Nurse, RN to join our behavioral health team. The role supports pre-certifications and continued authorization for psychiatric care within a multidisciplinary setting.

The qualified candidate will hold a GA RN license (or multistate) and have at least 2 years of psychiatric care and utilization review experience. This position may involve in-house coordination and collaboration with the care team.

Qualifications

• Registered Nurse license valid in GA or multi-state.
• Minimum 2 years of psychiatric healthcare experience.
• Experience with utilization review processes.

Responsibilities

• Review clinical content of medical records.
• Participate in treatment team meetings with staff.
• Collaborate with physicians and treatment team to gather data for insurance precertifications and ongoing authorizations.
• Input pre-certifications and stay reviews into Midas system.
• Follow up on unfinished pre-certifications daily.
• Coordinate follow-ups with the treatment team as needed.
• Verify insurance coverage at month start and post patient payments into MS4.
• Gather and enter clinical criteria into computer systems as required.

Education

RN License (GA or Multistate)

Job description

Lighthouse Care Center of Augusta is seeking a dedicated Utilization Review Nurse, RN to join our behavioral health team. The role supports pre-certifications and continued authorization for psychiatric care within a multidisciplinary setting.

The qualified candidate will hold a GA RN license (or multistate) and have at least 2 years of psychiatric care and utilization review experience. This position may involve in-house coordination and collaboration with the care team.