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Behavioral Health Utilization Review Clinician

7/11/2025

Remote

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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