Behavioral Health Utilization Management Clinician, Experienced
About The Position
Your Role The Behavioral Health Utilization Management team performs prospective & concurrent utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationally recognized clinal criteria across multiple lines of business. The Behavioral Health Utilization Management Clinician, Experienced, will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role you will conduct clinical review of mental health and substance use authorization requests at various levels of care for medical necessity, coding accuracy, medical policy compliance and contract compliance.
Responsibilities
- Conduct clinical review of mental health and substance use authorization requests at various levels of care for medical necessity
- Coding accuracy
- Medical policy compliance
- Contract compliance
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What This Job Offers
Job Type
Full-time
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
No Education Listed
