Behavioral Health Utilization Review Registered Nurse
$57,244–$62,180 year
Hybrid · Rockford, Illinois, United States
Job Summary
Role involves performing first-level utilization reviews for behavioral health cases, certifying treatment for confinement when criteria and practice guidelines are met, and deferring to a second-level reviewer when needed. Collaborates with case managers and disease management nurses to ensure adherence to URAC guidelines and state/federal requirements. Maintains knowledge of current advances in medical care and demonstrates effective communication with hospital staff and providers. Schedule is Monday–Friday, 9:30 AM–6:00 PM, with remote/hybrid work options after training. Requires RN licensure and mental health/substance abuse experience; 3 years of acute clinical practice (5 years preferred).
Required Qualifications
- Registered Nurse with valid, unrestricted, current nursing license in the United States
- Mental Health or Substance Abuse experience
- Successful completion of UR nurse orientation program
- Minimum of 3 years recent acute clinical practice; 5 years preferred
- Managed care, disability or workers compensation experience helpful but not mandatory
- Customer service oriented
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