Nevada Licensed Behavioral Health Advocate

Job Summary

A company is looking for a Behavioral Health Senior Care Advocate.

Key Responsibilities

• Conduct utilization reviews for behavioral health services across multiple levels of care
• Evaluate clinical information to determine medical necessity and level of care
• Review and process medical necessity and administrative denials, and manage appeals cases

Required Qualifications

• RN or Master's degree in social work or related behavioral health field
• Active, unrestricted behavioral health license in the state of residence
• 3+ years of behavioral health clinical experience in an inpatient/acute or outpatient setting
• Familiarity with Medicaid and Commercial benefit structures and utilization management protocols
• Proficient in using clinical systems and electronic documentation platforms