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What We Offer

• Why This Role Matters

As a Utilization Review Clinician, you will play a critical role in ensuring the integrity and compliance of patient health records, while supporting patient care by driving accuracy and adherence to ensure accurate and compliant billing.

What You’ll Do

+ Location: Remote within Novant Health's hiring footprint states: CO, CT, FL, GA, ID, IN, KY, LA, MN, MO, MS, NC, NV, OH, OK, SC, SD, TN, TX, VA, WY.

+ Schedule - Monday - Friday, 8:00am - 5:00pm, occasional Sundays required.

+ Serve as a leader resource in the Utilization Review process, for the behavioral health specialty area.

+ Coordinate and conduct initial, concurrent, and retrospective medical necessity reviews.

+ Collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance.

+ Obtain prior authorization for behavioral health services.

+ All Utilization Review activities are performed in accordance with the current policies and procedures, mission, vision, and values of Novant Health.

What You’ll Need

Required:

+ Current RN or LCSW/LPC licensure in appropriate state.

+ 4 Year / Bachelors Degree, graduate of an accredited school of nursing, social work, or counseling.

Preferred:

+ Graduate Degree in Nursing/Social Work/Counseling.

+ 2+ years’ Behavioral Healthcare experience and Utilization Review or related experience.

What’s In It for You

+ The opportunity to work remotely within Novant's hiring footprint (technology provided).

+ Daytime hours, no holiday requirement.

+ Comprehensive benefits include health, dental, vision, and life insurance.

+ Retirement fund with matching contributions.

+ Tuition assistance for qualifying team members.

Job Opening ID

130413