Georgia Licensed Utilization Review Clinician

Job Summary

A company is looking for a Utilization Review Clinician - Behavioral Health.

Key Responsibilities

• Evaluates member's treatment for mental health and substance abuse to ensure appropriateness of care
• Performs prior authorization reviews to determine medical appropriateness according to regulatory guidelines
• Conducts concurrent reviews of behavioral health inpatient cases for treatment needs and discharge planning

Required Qualifications, Training, and Education

• Graduate of an Accredited School of Nursing or Bachelor's degree with 2 - 4 years of related experience
• Master's degree for behavioral health clinicians is required
• License to practice independently as per state requirements
• Clinical knowledge related to mental health and substance abuse treatment plans preferred
• Experience working with healthcare teams in mental health and substance abuse services preferred