TX/CA Licensed Utilization Review Clinician

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 reviews and concurrent reviews of behavioral health inpatient services
• Analyzes member data to improve service quality and provides education regarding the utilization process

Required Qualifications

• 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
• License to practice independently in TX and/or CA
• Clinical knowledge related to mental health and substance abuse preferred
• Experience working with healthcare providers in mental health and substance abuse services preferred