Licensed Behavioral Health Clinician
Virtual Vocations Inc
To support our inpatient and outpatient Behavioral Health Medicare Plan, the full-time remote Utilization Review Clinician - Behavioral Health will perform clinical reviews, assess care related to mental health and substance abuse, and determine the medical appropriateness of services. Key responsibilities: Evaluate members' treatment for mental health and substance abuse to ensure the appropriateness of care levels Perform prior authorization reviews and concurrent reviews for behavioral health inpatient services Analyze behavioral health member data to enhance service quality and utilization Required qualifications: Master's degree required for behavioral health clinicians License to practice independently, such as LCSW, LMHC, LPC, LMFT, or LMHP 2-4 years of related experience in behavioral health or utilization management Strong knowledge of medical necessity criteria and managed care principles Experience working with healthcare teams to review care services related to mental health and substance abuse preferred
Vacancy posted 13 hours ago
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