Registered Nurse (RN) / Behavioral Health Reviewer
K-Tek Resourcing LLC
Dice Job Match Score™
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Job Details
Skills
- Authorization
- Back Office
- Medicaid
- Medicare
- Regulatory Compliance
- Registered Nurse
- Applied Behavioral Analysis
- ABA
- Behavioral Health (BH)
- Prior Authorization Reviews
- Clinical Reviews
- Medical Necessity Determination
- Care Coordination
- Appeals Review
- Utilization Management
- CMS
- NCQA
- Clinical Documentation
- Electronic Medical Records
- Managed Care
- Health Plan Operations
- LMHC
- LCSW
Summary
Role: Registered Nurse (RN) / Behavioral Health Reviewer Location: Remote USA
Mandatory:
- Minimum 2+ years of Applied Behavioral Analysis (ABA) experience
- Active US RN License OR LMHC / LCSW Certification
- Experience with Prior Authorization, Clinical Reviews, Appeals, or Behavioral Health services
- Knowledge of Medicaid/Medicare or Health Plan operations preferred
Job Responsibilities:
- Review ABA and Behavioral Health cases for medical necessity
- Handle prior authorizations and appeals
- Work with providers regarding level of care/services
- Support treatment planning and patient progress reviews
- Maintain compliance and clinical documentation
Note: Remote back-office/non-bedside role.
- Dice Id: 10411276
- Position Id: 8977464
- Posted 15 hours ago
Company Info
Vision
To be a trusted partner and advisor to our customers
Mission
At K-Tek we believe in understanding the specific needs of the customer and tailor-creating innovative solutions to meet these needs. We invest in our employees and customers. We build a relation of trust with our customers through empathy, solutions and being the first time right.
Who We Are & What We Do
K-Tek Resourcing is a consulting organization with offices in Houston TX and St. Paul, MN. It is supported by 2 global delivery centers, located in India. With its global employee strength of over 250, K-Tek has been supporting its clients for over 9 years. We have been consistently achieving a growth of 30% Year on Year. We have an extensive experience of working in domains including BFSI, Retail, Healthcare and Pharma, Oil & Gas, Travel & Hospitality and Insurance. The technologies we service are IT Infrastructure, Mobile Technologies, Cloud & Big Data Solutions. We understand the needs of our customers and provide them with customized solutions and resources with the tenet of being the "First Time Right".
Values
-Commitment to our customers success through Integrity
-Excellence through Quality
-Growth through customer value creation
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