Nurse Practitioner, Behavioral Health UM (PMHNP/Remote)

About the Role

Join Molina Healthcare as a Behavioral Health NP – Remote, Utilization Management in United States.

Key Responsibilities

• Performs Behavioral Health utilization management reviews for inpatient, outpatient, and intermediate

• level services using nationally recognized criteria (e. g., MCG, InterQual, ASAM).

• Reviews medical documentation to determine the medical necessity, level of care, and continued stay appropriateness for behavioral health services.

• Collaborates with Behavioral Health Medical Directors on complex or borderline cases, ensuring consistent application of criteria and alignment with regulatory standards.

Requirements

• Performs Behavioral Health utilization management reviews for inpatient, outpatient, and intermediate

• level services using nationally recognized criteria (e. g., MCG, InterQual, ASAM).

• Reviews medical documentation to determine the medical necessity, level of care, and continued stay appropriateness for behavioral health services.

• Collaborates with Behavioral Health Medical Directors on complex or borderline cases, ensuring consistent application of criteria and alignment with regulatory standards.

Benefits & Compensation

• and compensation package.

• Molina Healthcare is an.

Work Schedule

• Full-Time position.

• Remote position - work from anywhere.

Apply to join Molina Healthcare as a Behavioral Health NP – Remote, Utilization Management.