Licensed Utilization Review Clinician

Job Summary

To support a growing treatment team, the full-time Licensed Utilization Review Clinician will conduct utilization reviews, peer reviews, and pre-certifications while collaborating with clinical teams and managing insurance communications remotely during MST/CST hours.

Key responsibilities:

• Complete and manage all authorizations for designated programs, including prior authorizations and peer-to-peer reviews
• Engage in clinical rounds to provide feedback and recommendations for authorization of clinically indicated services
• Communicate with billing and program leadership regarding client authorization status and potential denials

Required qualifications:

• Master's Degree in Psychology, Social Work, Nursing, Nutrition, or a mental health-related field
• At least one year of experience with insurance authorizations and managed care
• Preferred experience providing direct care to individuals with eating disorders
• Licensed behavioral health clinician/provider or Registered Dietitian (RD)