Job Summary
A company is looking for a Utilization Review Clinician - Behavioral Health.
Key Responsibilities
- Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization reviews and concurrent reviews for behavioral health services
- Analyzes member data to enhance quality and utilization of services
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 as per state requirements
- Clinical knowledge of mental health and substance abuse treatment plans preferred
- Experience working with healthcare providers in mental health and substance abuse settings preferred
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