Behavioral Health Utilization Management Reviewer

Overview

As a Behavioral Health Utilization Management Reviewer, you will play a vital role in ensuring that the mental health services provided to our patients are both necessary and effective. This position involves evaluating treatment requests, consulting with providers, and making informed decisions based on clinical guidelines and patient needs.

Responsibilities

• Review and authorize treatment requests, including initial, concurrent, urgent, and retrospective requests.
• Consult with providers regarding authorization requests and patient care.
• Collaborate with medical professionals on complex cases involving patient safety, medication, or treatment effectiveness.
• Develop clear and informative communications to patients and providers regarding authorization decisions and appeal processes.
  
  

Qualifications

• Master’s degree in a human services field with clinical licensure (e.g., LCSW, LCMHC, LPA, LMFT, RN).
• Minimum of 2 years of post-Master’s experience in behavioral health.
• Strong understanding of mental health principles, treatment methods, and diagnostic categories.
• Knowledge of person-centered and recovery philosophies.
• Proficiency in assessment and intervention techniques for mental health, developmental disabilities, and substance use disorders.
• Familiarity with the 1915 (b) © waiver and psychiatric medications.
• Excellent computer skills, including proficiency in Microsoft Office.
• Ability to communicate effectively with providers, patients, and families.
• Strong organizational and time management skills.
  
  

Benefits

• Competitive salary and benefits package.
• Opportunities for professional growth and development.
• Remote work options available.
  
  

Employment Type: Full-Time