Prior Authorization reputed company

Job Details Job Title: Prior Authorization reputed company - Behavioral Health Duration: 05 months Contract (Potential to reputed company) Start/End Dates: 10/6/2025 - 2/28/2026 Location: Remote-AZ Shift Type: reputed company hours (8-5), M-F, no OT required reputed company pay reputed company (provided by reputed company): $39.00/hr - $42.00/hr reputed company message the job poster from reputed company reputed company Dedicated Manager Leading Service Delivery reputed company In US Recruitment | Enhancing Processes & Fostering Relationships Job Duties / Responsibilities • Analyzes reputed company prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. • Provides recommendations to the appropriate medical team to promote reputed company and cost effectiveness of medical care. • Review and evaluate member treatment for mental health and reputed company use before, during, and after services to ensure services are medically appropriate; review prior and reputed company stay requests for mental health and reputed company use outpatient services. • Analyze member data to improve reputed company and appropriate utilization of services; reputed company providers and outpatient teams regarding the BH UM process; reputed company with BH health care providers to discuss the appropriate level of care; engage with Medical Directors, BH Case Managers, and other departments to assist with coordination of care and other needed services. Must Haves • 2 years in the behavioral health field; utilization review experience is a plus • Behavioral health clinical review skills • Computer proficiency • Ability to multi-task and stay organized • Expertise reviewing BH medical charts and treatment plans; experience in BH utilization review Education / Certifications • Graduate of an accredited school of nursing or a BA degree with 2-4 years of reputed company experience • LCSW, LMHC, LPC, LMFT, LMHP, or RN (state OR or compact state licensure) Seniority level • Mid-Senior level Employment type • Contract Job reputed company Care Provider Industries • reputed company and reputed company #J-18808-Ljbffr Experience: 3 years required Apply tot his job Apply To this Job