Texas Licensed Utilization Review Clinician
Job Summary
To support the Texas Ambetter Inpatient Behavioral Health population, the full-time Texas Licensed Utilization Review Clinician will perform clinical reviews and assess care related to mental health and substance abuse, working remotely on a schedule of four 10-hour shifts per week with Saturday availability required.
Key responsibilities
- Evaluates member treatment for mental health and substance abuse to ensure medical appropriateness of care
- Performs prior authorization reviews and concurrent reviews of behavioral health inpatient services
- Educates providers, members, and families regarding the behavioral health utilization process
Required qualifications
- Graduate of an accredited nursing school or Bachelor's degree with 2-4 years of related experience
- Master's degree for behavioral health clinicians required
- License to practice independently as an LCSW, LMHC, LPC, LMFT, LMHP, or RN
- Preferred clinical knowledge of mental health and substance abuse treatment plans
- Experience working with healthcare providers in behavioral health settings preferred
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