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
Clinical Reviewer • Norfolk, Virginia, United States