Behavioral Health Utilization Review RN

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 reviews and concurrent reviews for behavioral health services
• Analyzes behavioral health data to enhance service quality and utilization

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
• State licensure as a Clinical Social Worker, Mental Health Counselor, Professional Counselor, Marriage and Family Therapist, or Registered Nurse is required
• Clinical knowledge related to mental health and substance abuse treatment plans is preferred
• Experience working with healthcare providers in behavioral health is preferred