Licensed Behavioral Health Clinician
Job Summary
To support the inpatient and outpatient Behavioral Health Medicare Plan, the full-time remote Licensed Behavioral Health Clinician will perform clinical reviews and authorization determinations related to mental health and substance abuse, ensuring the appropriateness of care and services provided to members.
Key responsibilities:
- Evaluates treatment for mental health and substance abuse to ensure medical appropriateness of care
- Conducts prior authorization reviews and concurrent reviews for behavioral health inpatient services
- Analyzes member data to enhance quality and utilization of behavioral health services
Required qualifications:
- Master's degree in a behavioral health field required
- License as a Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Licensed Marital and Family Therapist (LMFT), or Licensed Mental Health Professional (LMHP) required
- Graduate of an accredited nursing school or bachelor's degree with 2-4 years of related experience
- Clinical knowledge in reviewing treatment plans for mental health and substance abuse preferred
- Experience in utilization management or working with healthcare providers in behavioral health preferred
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