Admissions and Utilization Review Nurse

Why PsychPlus?

The current delivery model for mental health care is broken in this country. PsychPlus set out on a mission to reimagine how mental health care is delivered to every American. Our goal is to provide a digital-first, modern approach to psychiatry and therapy. We provide care both in-person at our offices across Texas and virtually so our patients can be seen at their convenience.

Through a combination of exceptional medical and psychological care and best-in-class technology, we provide an unparalleled approach that serves our patients needs in an integrated way. Join us in our mission to ensure that every person has access to affordable and accessible mental health care.

About The Role

We are seeking a dedicated Admissions & Utilization Review Nurse to join our clinical operations team. In this role, you will play a critical part in managing patient admissions and ensuring the delivery of high-quality, cost-effective care through meticulous utilization review. This is a dynamic opportunity to impact the patient experience from the moment of referral through the continuum of care in our inpatient behavioral health programs. You will evaluate clinical information to determine admission suitability, ensure medical necessity, and collaborate with internal teams to coordinate seamless patient transitions. This position serves as a vital liaison between patients, clinical staff, and insurance providers, helping PsychPlus deliver compassionate, efficient, and compliant mental healthcare.

Responsibilities

• Evaluate incoming referrals for appropriateness and compliance with established admission criteria.
• Perform utilization reviews to determine and document the medical necessity of services.
• Collaborate closely with interdisciplinary teams to ensure smooth and timely patient admissions.
• Communicate with insurance providers to obtain pre-authorizations and ongoing approvals.
• Serve as a liaison between clinical staff, patients, families, and external stakeholders to promote alignment and transparency in care planning.
• Monitor and track length of stay and level of care to optimize clinical outcomes and cost-effectiveness.
• Participate in compliance audits, process improvement initiatives, and staff education to support the broader goals of the clinical operations team.

Requirements

• Registered Nurse (RN) with an active, unencumbered license in Texas.
• At least 2 years of experience in admissions, utilization review, case management, or behavioral health services.
• In-depth understanding of medical necessity criteria (e.g., MCG, InterQual) and insurance authorization processes.
• Excellent organizational skills with strong attention to detail.
• Strong verbal and written communication skills; ability to work cross-functionally with clinical and non-clinical teams.
• Proficiency with EHR systems and healthcare documentation.
• Ability to manage multiple priorities in a fast-paced, mission-driven environment.

Perks

Our goals are to find the best, attract the best, and offer a competitive salary—which is why we prioritize the quality of the hire over the number of hires. We offer zero-stress medical, dental, and vision coverage, competitive salaries, and a generous PTO policy. We are excited to tell you about a few "perks" we offer that are unique to Psychplus. We've spent time thinking through what it means to be a modern mental health company and how we can better align these additional perks with our mission and values.

Additional Information

The expected base pay for this role will be between $80,000 to $110,000 annually at the commencement of employment. However, base pay will be determined on an individualized basis and will be impacted by location and years of experience. Further, base pay is only part of the total compensation package, which, depending on the position, may also include incentive compensation, discretionary bonuses, other short and long-term incentive packages, and other Psychplus Health-sponsored benefits.

So—what do you think?

If you've made it this far, well, we're excited to meet you too. Just one more thing that we want you to remember: we pride ourselves on our meritocratic, performance-driven culture. We are a startup and move at the speed of light. You might be required to wear multiple hats at any given time. There's no room for complacency. Your scope of responsibility and opportunity to make a difference will be uncapped at Psychplus, but we need your commitment that you will work tirelessly for our patients, parents, and partners. At the end of day, our team is committed to helping you succeed at Psychplus because when you succeed, our patients succeed, and we get one step closer to solving the mental health crisis. We're hopeful that this role will give you the experience to go and do whatever you want in life but the fulfillment to make you never want to leave our team. We look forward to solving the mental health crisis, together.

Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Psychplus, please go directly to our Careers Page:

Psychplus will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Psychplus will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Psychplus will only be sent from @psychplus.com email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services.

At Psychplus, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide accessible and affordable mental healthcare to every one of our patients.

Psychplus applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.