Utilization Review Clinician, Advocate, Remote

Utilization Review Clinician, Advocate, Remote

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Utilization Review Clinician/Advocate needed for remote Per Diem position. The Utilization Review Clinician/Advocate provides telephonic care review and authorization determinations for psychiatric, and substance use treatment services, including prospective, concurrent, and discharge reviews. This role evaluates appropriate levels of care based on medical necessity criteria, collaborates with treatment teams and Physician Advisors regarding authorization decisions and alternative treatment options, and provides members and providers with information on behavioral health benefits and community resources.

Candidates must hold an LSW and have at least five years of combined experience in behavioral health and/or substance use treatment settings, along with Utilization Review or Care Management experience. Strong telephonic communication, negotiation, and relationship-building skills are required, as well as the ability to manage deadlines, prioritize tasks, and effectively coordinate care with providers, members, and families. Proficiency with computer systems and documentation is essential.

This position is currently accepting applications.