Tennessee Licensed Behavioral Health Manager

Job Summary

A company is looking for a Behavioral Health Clinical Review Manager.

Key Responsibilities

• Assist non-clinical staff in administrative reviews and coordinate care referrals
• Perform comprehensive provider and member appeals, including denial interpretation and retrospective claim reviews
• Present cases during clinical rounds and work independently in a fast-paced environment

Required Qualifications

• Current, active unrestricted Tennessee license in Nursing (RN) or a behavioral health field (Master's level or above)
• 3 years of clinical behavioral health or substance use disorder experience required
• Knowledge of community care resources and behavioral health care levels
• 3+ years of experience in Psychiatric and/or Substance Use treatment
• Prior experience in Utilization Management or Managed Care