WA Licensed Utilization Review Clinician

Job Summary

To support a growing Medical Management/Health Services team, the full-time WA Licensed Utilization Review Clinician will perform clinical reviews for mental health and substance abuse, ensuring the appropriateness of care and services in a remote setting.

Key responsibilities

• Evaluate treatment for mental health and substance abuse to ensure medical appropriateness before, during, and after services
• Conduct prior authorization reviews and concurrent reviews of behavioral health inpatient cases
• Provide education to providers, members, and families regarding the behavioral health utilization process

Required qualifications

• Master's degree for behavioral health clinicians required
• License to practice independently in WA, such as LCSW, LMHC, LPC, LMFT, or RN
• 2-4 years of related experience in mental health and substance abuse
• Clinical knowledge of treatment plans related to mental health and substance abuse preferred
• Experience working with healthcare teams to review care services preferred