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 appropriateness of care
- Performs prior authorization reviews for mental health and substance abuse services in accordance with regulatory guidelines
- Analyzes behavioral health member data to enhance quality and utilization of services
Required Qualifications
- 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 treatment plans related to mental health and substance abuse preferred
- Experience working with providers and healthcare teams in behavioral health preferred
Comments