Licensed Utilization Review Clinician

Job Summary

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

Key Responsibilities

• Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness
• Performs prior authorization and concurrent reviews related to mental health and substance abuse
• Provides education to providers, members, and families regarding the behavioral health utilization process

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 required
• License to practice independently or state-required licensure
• Clinical knowledge related to mental health and substance abuse preferred
• Experience working with healthcare teams in reviewing care services preferred