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 in accordance with guidelines
- Conducts concurrent reviews of behavioral health inpatient cases for treatment needs and discharge planning
Required Qualifications
- Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience
- Must have a Georgia License to practice independently
- Master's degree for behavioral health clinicians is required
- Preferred clinical knowledge related to mental health and substance abuse treatment plans
- Experience working with providers and healthcare teams in mental health and substance abuse services is preferred
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