Preservice Review Nurse - Behavioral Health - Remote in PST or MT

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration of relevant clinical information Function as a member of a self-directed team to meet specific individual and team performance metrics Ability to communicate in writing and verbally, all types of benefit determinations including decisions regarding coverage guidelines Telephonic discussion with health care providers and/or members to explain benefit coverage determinations and to obtain additional clinical information Acts as a resource for others with less experience Work independently and collaborating with Medical Directors and non-clinical partners Adapt to a highly changing environment and a heavy case load