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 appropriateness of care
- Performs prior authorization and concurrent reviews related to mental health and substance abuse
- Provides education on BH utilization processes and collaborates with healthcare providers to enhance care quality
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 for behavioral health clinicians is required
- License to practice independently as per state requirements (LCSW, LMHC, LPC, LMFT, LMHP, or RN)
- Clinical knowledge in reviewing treatment plans for mental health and substance abuse is preferred
- Experience working with healthcare teams in mental health and substance abuse care is preferred
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