Minnesota Licensed Clinical Reviewer

Job Summary

A company is looking for a Clinical Reviewer - Licensed Behavioral Health (Substance Abuse) to join their team.

Key Responsibilities

• Review and interpret patient records against ASAM criteria to determine medical necessity and appropriateness of care
• Maintain current knowledge related to review processes and clinical practices, attending training and meetings as required
• Assess and manage daily workload, ensuring accuracy and timeliness of review cases within contract requirements

Required Qualifications

• Active, unrestricted Licensed Alcohol and Drug Counselor (LADC) issued by the Minnesota Board of Behavioral Health and Therapy (BBHT)
• 3+ years of direct clinical work experience as a mental health professional
• 1+ years of experience in Utilization Review (UR), Utilization Management (UM), or Prior Authorization
• In-depth understanding of ASAM criteria and its application in clinical settings
• Familiarity with medical records structure and terminology