Job Summary
A company is looking for a Utilization Review Clinician - BH.
Key Responsibilities
- Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization reviews and concurrent reviews related to behavioral health
- 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 required
- License to practice independently or state-required licensure
- Clinical knowledge related to mental health and substance abuse treatment plans preferred
- Experience working with healthcare teams in behavioral health preferred
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