Location: Omaha, NE
Location Type: Omaha – Remote
This department is available Monday – Friday from 10:00 AM-6:30 PM CST. Hours for this role are based on business need between that timeframe. The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
- Minimum of Associate’s Degree in Nursing
- Registered nurse with active Compact Licensure and no disciplinary actions
- Minimum 3 years of post-degree Clinical or Behavioral Health experience in direct patient care
- Adept experience working with computers, including proficiency with Microsoft Office products: Word, Excel and MS Teams and OneNote
- Must be able to work Monday – Friday from 10:00 AM-6:30 PM CST.
- WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
- Satellite and Wireless Internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Advanced nursing degree: BSN or MSN
- Experience with Behavioral Health utilization management experience, performing medical necessity reviews against criteria such as MCG, ASAM, Interqual, etc.
- 1 year of managed care experience working directly with insurance companies
- Use of EMR systems
- Additional Non-compact nursing licenses
- Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish
Typically requires Bachelor’s degree or equivalent and less than 5 years of technical experience
Scheduled Weekly Hours
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