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 reviews for mental health services in accordance with regulatory guidelines
• Conducts concurrent reviews of behavioral health inpatient cases for treatment needs and discharge planning

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 and ability to assess treatment plans for mental health and substance abuse
• Preferred experience working with providers and healthcare teams in behavioral health