Job Summary
A company is looking for a Clinical Reviewer - Licensed Behavioral Health (Substance Abuse) - Part-time (Remote U.S.).
Key Responsibilities
- Review and interpret patient records against ASAM criteria to determine medical necessity and appropriateness of care
- Ensure accuracy and timeliness of review cases within contract requirements and assess daily workload
- Function as a liaison for provider customer service issues and maintain current knowledge related to review processes
Required Qualifications
- Active, unrestricted license in Minnesota as LPCC, LMFT, or LICSW, or eligibility to obtain within six months
- 3+ years of direct clinical work experience as a mental health professional
- 1+ years of experience in Utilization Review, Utilization Management, or Prior Authorization
- In-depth understanding of ASAM criteria and familiarity with medical records structure and terminology
- Strong clinical assessment capabilities and proficiency in medical record abstraction
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