Job Summary
A company is looking for a Utilization Review Clinician - BH.
Key Responsibilities
- Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization 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 is required
- State licensure as LCSW, LMHC, LPC, LMFT, LMHP, or RN is required
- Clinical knowledge of mental health and substance abuse treatment plans is preferred
- Experience working with healthcare teams in behavioral health is preferred
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