Licensed Utilization Review Clinician

Job Summary

A company is looking for a Utilization Review Clinician - BH.

Key Responsibilities

• Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
• Performs prior authorization and concurrent reviews related to mental health and substance abuse
• Analyzes behavioral health member data to enhance service quality and utilization

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
• License to practice independently as per state requirements
• Clinical knowledge of treatment plans related to mental health and substance abuse preferred
• Experience working with healthcare teams to review care services preferred