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North Carolina Licensed Utilization Review Clinician

5/29/2025

N/A

Job Summary

A company is looking for a Utilization Review Clinician - Behavioral Health.

Key Responsibilities
  • Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
  • Performs prior authorization and concurrent reviews related to behavioral health services
  • Analyzes member data and provides education regarding behavioral health utilization processes
Required Qualifications 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 required
  • Licensed Clinical Social Worker (LCSW) or equivalent licensure required
  • Clinical knowledge of mental health and substance abuse treatment plans preferred
  • Experience working with healthcare teams in behavioral health preferred

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