Licensed Behavioral Health ReviewerVirtualVocations • Modesto, California, United States
Licensed Behavioral Health Reviewer
VirtualVocations • Modesto, California, United States
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A company is looking for a Behavioral Health Utilization Management Reviewer.
Key Responsibilities
Conduct medical necessity reviews for inpatient and outpatient services
Collaborate with members and providers to gather necessary information for reviews
Apply medical health benefit policy to authorize services and identify care coordination opportunities
Required Qualifications
Registered Nurse : Associate's Degree in Nursing required; Bachelor's preferred
Licensed Social Worker : Master's Degree in Social Work required
Minimum of 2 years of experience in behavioral health and substance use disorder
Utilization management experience in a managed care organization preferred
Current and active professional licensure required for LSW or RN
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