Behavioral Health Utilization Review Clinician

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