Licensed Behavioral Health Reviewer

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