North Carolina 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 reviews and concurrent reviews for behavioral health inpatient services
• Analyzes member data to enhance service quality and utilization

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
• State licensure as a clinical social worker, mental health counselor, professional counselor, marital and family therapist, or registered nurse is required
• Clinical knowledge of treatment plans related to mental health and substance abuse is preferred
• Experience working with healthcare providers in mental health and substance abuse review is preferred