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Utilization Review Clinician
- Novant Health (NC)
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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
+ Schedule - 32-hours per week with schedule flexibility based on departmental need, weekends as needed, most holidays 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 from 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 approved hiring footprint.
+ Daytime hours.
+ Comprehensive benefits include health, dental, vision, and life insurance.
+ Retirement fund with matching contributions.
+ Tuition assistance for qualifying team members.
Why Choose Novant Health?
At Novant Health, we believe remarkable care starts with compassion for our patients, our communities, and each other. We value belonging, courage, personal growth, and teamwork, creating a space where everyone is respected, supported, and safe to show up as their full selves.
Job Opening ID
135076
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