North Carolina Licensed Utilization Review Clinician
Job Summary
To support behavioral health services, the full-time remote North Carolina Licensed Utilization Review Clinician will perform clinical reviews and assessments related to mental health and substance abuse, ensuring the appropriateness of care and services while working Tuesday through Saturday from 8:00 AM to 5:00 PM.
Key responsibilities
- Evaluates and monitors members' treatment for mental health and substance abuse to ensure medical appropriateness
- Performs prior authorization and concurrent reviews related to behavioral health to assess treatment needs and discharge planning
- Interacts with healthcare providers and engages with leadership to enhance the quality and efficiency of care
Required qualifications
- Active North Carolina clinician or RN license required
- Master's degree for behavioral health clinicians required
- 2 - 4 years of related experience in behavioral health and utilization review preferred
- Knowledge of mental health and substance abuse utilization review process preferred
- Experience working with healthcare teams to review care services related to mental health and substance abuse preferred
Complete Job Description
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