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 reviews and concurrent reviews related to mental health and substance abuse
- Analyzes behavioral health member data and provides education to providers and members regarding the utilization process
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 or state-required licensure
- Clinical knowledge of treatment plans related to mental health and substance abuse preferred
- Experience working with healthcare teams in mental health and substance abuse care preferred
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