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Washington State Licensed Utilization Specialist
Job Summary
A company is looking for a Care Review Clinician II.
Key Responsibilities
- Process concurrent reviews and prior authorizations for healthcare members
- Assess services for optimal outcomes and compliance with regulations
- Collaborate with internal teams to enhance continuity of care
Required Qualifications
- Licensed in Washington State (WA) as a Social Worker, Mental Health Counselor, Marriage Family Therapist, or Psychiatric Nurse
- 2-4 years of clinical practice experience, preferably in hospital nursing or utilization management
- Proficient in Interqual, NCQA, and state/federal regulations
- Proficient in Microsoft Office Suite and relevant computer applications
- Adhere to HIPAA guidelines and maintain confidentiality
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COMPLETE JOB DESCRIPTION
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