Job Summary
A company is looking for a Utilization Review Clinician - Behavioral Health.
Key Responsibilities
- Evaluate members' treatment for mental health and substance abuse to ensure medical appropriateness
- Perform prior authorization reviews and concurrent reviews for behavioral health services
- Provide education to providers and families regarding the behavioral health utilization process
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 required for behavioral health clinicians
- State licensure as a Clinical Social Worker, Mental Health Counselor, Professional Counselor, or equivalent required
- Clinical knowledge related to mental health and substance abuse assessments preferred
- Experience working with healthcare teams in behavioral health preferred
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