Licensed Clinical Reviewer

A company is looking for a Clinical Reviewer of Behavioral Health.

Key Responsibilities

Review medical records to determine medical appropriateness based on contract requirements

Monitor and adjust daily workload to meet departmental demands and ensure timely case reviews

Act as a liaison for providers and assist in quality monitoring and improvement activities

Required Qualifications

Active unrestricted Licensed Mental Health Professional (LMHP) in relevant fields

Bachelor's Degree or higher in a related field from an accredited institution

At least 1 year of experience in Prior Authorization, Utilization Review, or Utilization Management

Ability to work alternating weekends