Job Summary
A company is looking for a Utilization Review Clinician - Behavioral Health.
Key Responsibilities
- Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization and concurrent reviews related to behavioral health services
- 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 is required
- License to practice independently or state-required licensure is necessary
- Preferred clinical knowledge of treatment plans for mental health and substance abuse
- Experience working with healthcare providers in mental health and substance abuse settings is preferred
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