Pennsylvania Licensed Behavioral Health Clinician

Job Summary

To support a growing healthcare team, a Pennsylvania Licensed Behavioral Health Clinician will manage remote case evaluations and authorizations for medically necessary services while collaborating with providers and ensuring compliance with regulatory requirements on a contract basis.

Key responsibilities

• Reviews medical and treatment records to assess behavioral health conditions and determine medical necessity for services
• Collaborates with providers to clarify treatment plans and refers cases not meeting criteria to the Medical Director
• Maintains compliance with state and federal regulations while documenting all key functions accurately

Required qualifications

• Active RN, LSW, LCSW, LPC, or LMFT license to practice in Pennsylvania
• 3+ years of Behavioral Health clinical experience in a healthcare setting
• Prior experience in Behavioral Health utilization management is desirable
• Medical management or precertification experience preferred
• Proficiency in Microsoft Office Suite and the ability to learn new systems