North Carolina Licensed Utilization Review Clinician

Job Summary

A company is looking for a Utilization Review Clinician.

Key Responsibilities

• Coordinate and conduct initial, concurrent, and retrospective medical necessity reviews
• Collaborate with physicians and healthcare team members to ensure regulatory compliance
• Perform Utilization Review activities in accordance with established policies and procedures

Required Qualifications, Training, and Education

• Bachelor's degree required; graduate of an accredited school of nursing, social work, or counseling required
• Graduate degree in Nursing, Social Work, or Counseling preferred
• Minimum of two years of Behavioral Healthcare experience and Utilization Review or related experience preferred
• Current RN or LCSW/LPC licensure in the appropriate state required