Kentucky Licensed Utilization Review Clinician
Job Summary
To support the Kentucky market, the full-time Kentucky Licensed Utilization Review Clinician will perform clinical reviews and assessments related to mental health and substance abuse, ensuring the appropriateness of care and services in a fully remote environment.
Key responsibilities
- Evaluates treatment for mental health and substance abuse to ensure medical appropriateness before, during, and after services
- Conducts prior authorization reviews and concurrent reviews of behavioral health inpatient cases
- Analyzes member data to enhance the quality and utilization of behavioral health services
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 is required
- Licensure as LCSW, LMHC, LPC, LMFT, LMHP, or RN is required
- Clinical knowledge of mental health and substance abuse treatment plans is preferred
- Experience working with healthcare providers on mental health and substance abuse services is preferred
Complete Job Description
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