Behavioral Health Clinician

Job Summary The Behavioral Health Clinical Reviewer is responsible for conducting administrative and process-based reviews of medical records to ensure compliance with medical necessity criteria, regulatory guidelines, and contractual requirements. This role evaluates behavioral health services for accuracy, appropriateness, and completeness. This is a non-direct care position requiring strong clinical expertise in behavioral health. Key Responsibilities Conduct prospective, concurrent, and retrospective reviews of behavioral health services Evaluate medical records to determine medical necessity and adherence to established guidelines Ensure accuracy, quality, and timeliness of all reviews Manage daily workload and review queues to meet productivity standards Collaborate with internal teams on quality improvement initiatives Serve as a liaison for providers, addressing inquiries and resolving service-related issues Maintain current knowledge of behavioral health practices, policies, and review criteria Participate in team meetings and ongoing training Ensure compliance with HIPAA and all organizational policies Required Qualifications Active, unrestricted Arkansas license in good standing in one of the following:

LCSW, LMSW

LAMFT, LMFT

LAC, LPC

LPE, LPE-I

Master’s degree in Behavioral Health or a related field from an accredited institution Minimum of 2+ years of experience in a behavioral health setting, including utilization review or case management Strong knowledge of medical, psychiatric, and psychological terminology Experience reviewing mental health assessments and treatment plans Understanding of behavioral health services across inpatient and outpatient settings Ability to handle confidential HIPAA information with discretion Strong interpersonal, organizational, and communication skills Ability to collaborate effectively with providers and stakeholders Preferred Qualifications Experience working with child and adolescent populations Experience in Utilization Review (UR) or Utilization Management (UM) Clinical quality review and medical record evaluation experience Familiarity with Arkansas Medicaid medical necessity criteria Knowledge of Arkansas Medicaid behavioral health policies and procedures Proficiency with automated review systems and Microsoft Office Suite #J-18808-Ljbffr Astyra Corporation