Oregon Licensed Utilization Review Clinician

Job Summary

To support Oregon Medicaid, the full-time Oregon Licensed Utilization Review Clinician will conduct clinical reviews and assessments related to mental health and substance abuse services, ensuring medical appropriateness for both inpatient and outpatient care in a fully remote setting.

Key responsibilities

• Evaluates member treatment for mental health and substance abuse to ensure appropriateness of care
• Performs prior authorization reviews and concurrent reviews of behavioral health inpatient services
• Analyzes behavioral health data to improve service quality and utilization

Required qualifications

• Master's degree in a relevant field required
• Independent clinical licensure (LCSW, LMHC, LPC, LMFT, LMHP, or RN) required
• 2-4 years of experience in behavioral health and utilization management or review
• Clinical knowledge of mental health and substance abuse treatment plans preferred
• Experience working with healthcare providers in behavioral health settings preferred