Job Summary
A company is looking for a Clinical Reviewer (Substance Abuse).
Key Responsibilities
- Review and interpret patient records against ASAM criteria to determine medical necessity and appropriateness of care
- Assure accuracy and timeliness of review cases within contract requirements and collaborate on quality monitoring activities
- Maintain current knowledge related to review processes and serve as a liaison for provider customer service issues
Required Qualifications
- Active unrestricted LPCC, LMFT, or LICSW in the State of Minnesota, or ability to obtain licensure upon job offer
- Minimum three years of direct clinical work as a mental health professional in various clinical settings
- At least one year of experience in Utilization Review and/or Prior Authorization
- Extensive knowledge of ASAM Criteria and medical record organization
- Strong clinical assessment and critical thinking skills
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