Tennessee Licensed Utilization Review ClinicianVirtualVocations • Oceanside, California, United States
Tennessee Licensed Utilization Review Clinician
VirtualVocations • Oceanside, California, United States
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A company is looking for a Utilization Review Clinician - Behavioral Health.
Key Responsibilities
Evaluate member's treatment for mental health and substance abuse to ensure medical appropriateness
Perform prior authorization reviews for mental health and substance abuse services in accordance with regulatory guidelines
Analyze behavioral health member data to enhance service quality and appropriate utilization
Required Qualifications, Training, and Education
Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience
Current state licensure as a Registered Nurse or licensed clinician
Master's degree required for behavioral health clinicians
Preferred clinical knowledge in reviewing treatment plans for mental health and substance abuse
Experience working with healthcare teams in behavioral health services preferred
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Utilization Review • Oceanside, California, United States
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