Texas Licensed Utilization Review Clinician

Job Summary

A company is looking for a Utilization Review Clinician - Behavioral Health.

Key Responsibilities

• Evaluates member's treatment for mental health and substance abuse to ensure medical appropriateness
• Performs prior authorization reviews and concurrent reviews for behavioral health inpatient services
• Provides education to providers, members, and families regarding the behavioral health utilization process

Required Qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience, or a Master's degree in behavioral health with preferred experience
• Clinical knowledge related to mental health and substance abuse treatment plans
• Experience with utilization review processes for behavioral health cases
• Direct experience in inpatient behavioral health settings is required
• Must hold relevant state licensure (LCSW, LMHC, LPC, LMFT, LMHP, or RN)