Texas Licensed Utilization Review Clinician

Job Summary

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

Key Responsibilities

• Evaluates treatment for mental health and substance abuse to ensure medical appropriateness
• Performs prior authorization reviews and concurrent reviews for behavioral health inpatient care
• Analyzes member data to improve service quality and provides education on the utilization process

Required Qualifications

• Independent clinical license (LCSW, LPC, LMFT, or RN) issued from the state of Texas
• Graduate of an accredited nursing program or bachelor's degree with 2-4 years of related experience
• Master's degree in a behavioral health-related field preferred
• Clinical knowledge of SPMI needs based on ASAM criteria
• Experience in Utilization Review related to Behavioral Health cases preferred