New York Licensed Utilization Review Clinician
Job Summary
Evaluating treatment plans for mental health and substance abuse, the full-time New York Licensed Utilization Review Clinician will perform clinical reviews, prior authorization assessments, and concurrent reviews while working remotely Monday through Friday from 8:30 a.m. to 5:00 p.m. Eastern Time.
Key responsibilities
- Evaluates member treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization and concurrent reviews of behavioral health services
- Analyzes member data to enhance service quality and utilization
Required qualifications
- Graduation from an accredited nursing school or a bachelor's degree
- 2-4 years of related experience in behavioral health
- Active New York State licensure or equivalent clinical license
- Master's degree for behavioral health clinicians is required
- Preferred experience with mental health and substance abuse utilization review processes
Complete Job Description
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