Licensed Clinical Care Reviewer

Job Summary

A company is looking for a Clinical Care Reviewer II - Behavioral Health.

Key Responsibilities

• Process medical necessity reviews for behavioral health care services and assist with discharge planning activities
• Coordinate care and facilitate timely discharge to appropriate levels of care
• Document and communicate with relevant stakeholders to ensure effective care coordination

Required Qualifications and Education

• Completion of an accredited registered nursing (RN) degree program or Bachelor's Degree in Social Work
• Minimum of three (3) years of clinical experience
• Utilization Management/Utilization Review experience preferred
• Medicaid/Medicare/Commercial experience preferred
• Current, unrestricted Registered Nurse (RN) Licensure or Licensed Social Worker (LSW) required