Remote Behavioral Health Utilization Review Nurse

Hines & Associates Inc; Oregon; Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Remote setting

Paid Holidays

Work-life balance

401k plan with company match

Job summary

Hines & Associates, Inc. is seeking a Nursing Review professional to validate outpatient and inpatient services against established criteria. The role focuses on certifying care when guidelines are met and coordinating with case managers across programs.

Responsibilities include evaluating plans of care, discharge planning, and maintaining awareness of URAC standards. This is a Monday–Friday position with standard daytime hours and remote setting options stated in the benefits.

Qualifications

• RN with active, unrestricted license in the United States

Responsibilities

• Completes first level reviews within scope of practice for clinical reviews.
• Certifies medical, disability and workers' compensation cases when criteria are met.
• Evaluates appropriateness of current plan of care and discharge needs.
• Maintains knowledge of URAC guidelines and company policies.

Skills

RN license

Mental Health

URAC guidelines

Customer service

Job description

Hines & Associates, Inc. is seeking a Nursing Review professional to validate outpatient and inpatient services against established criteria. The role focuses on certifying care when guidelines are met and coordinating with case managers across programs.

Responsibilities include evaluating plans of care, discharge planning, and maintaining awareness of URAC standards. This is a Monday–Friday position with standard daytime hours and remote setting options stated in the benefits.