Massachusetts Licensed Clinical Care Reviewer

Job Summary

Responsible for processing medical necessity reviews for behavioral health services, the full-time Massachusetts Licensed Clinical Care Reviewer will engage in care coordination, discharge planning, and collaborate with care partners while working remotely.

Key responsibilities:

• Complete prospective, concurrent, and retrospective reviews of behavioral health services
• Coordinate care and facilitate transitions to appropriate levels of care by engaging with collaborative partners
• Provide guidance to non-clinical staff and assist with special projects as requested

Required qualifications:

• Associates of Science (A.S) in Nursing, Bachelor of Science (B.S) in Social Work, or a Master's degree in a mental health-related field required
• Three (3) years of clinical experience required
• Current, unrestricted licensure as a Registered Nurse or relevant mental health professional required
• MCG Certification required or must be obtained within six (6) months of hire
• Utilization Management/Utilization Review experience preferred