Job Summary
A company is looking for a Utilization Review Clinician - Behavioral Health.
Key Responsibilities
- Evaluate member's treatment for mental health and substance abuse to ensure medical appropriateness
- Perform prior authorization and concurrent reviews related to mental health and substance abuse
- Provide education on behavioral health utilization processes to providers, members, and families
Required Qualifications
- Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience
- Independent clinical licensure is required (e.g., LCSW, LMHC, LPC, LMFT, LMHP, or RN)
- Master's degree for behavioral health clinicians is required
- Preferred experience in mental health and substance abuse utilization review processes
- Preferred experience working with healthcare teams to review care services
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