Licensed Utilization Review Clinician

Job Summary

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

Key Responsibilities

• Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
• Performs prior authorization and concurrent reviews related to behavioral health services
• Analyzes member data to enhance service quality and provides education on the utilization process

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 required for behavioral health clinicians
• State licensure as a Clinical Social Worker, Mental Health Counselor, Professional Counselor, or equivalent
• Preferred clinical knowledge of treatment plans for mental health and substance abuse
• Experience working with healthcare providers in behavioral health settings preferred