Job Summary
A company is looking for a Senior Utilization Review Clinician - Behavioral Health.
Key Responsibilities
- Perform clinical reviews and assess care related to mental health and substance abuse
- Manage complex prior authorization and concurrent reviews to ensure medical appropriateness of services
- Identify quality of care issues and collaborate with healthcare providers to improve service delivery
Required Qualifications
- Bachelor's degree and 4 - 6 years of related experience
- License to practice independently as a Clinical Social Worker, Mental Health Counselor, Professional Counselor, or Licensed Mental Health Professional
- Experience in behavioral health utilization review processes
- Ability to engage with medical directors and leadership for quality improvement
- Experience in training and mentoring new hires as a subject matter expert
Comments