Offer summary
Qualifications:
Graduate of an Accredited School Nursing or Bachelor's degree, 2–4 years of related experience, Master’s degree for behavioral health clinicians required, License to practice independently as required, Knowledge of mental health and substance abuse review process preferred.
Key responsabilities:
- Perform clinical reviews for mental health and substance abuse
- Conduct prior authorization reviews for care appropriateness
- Engage providers on level of care and treatment planning
- Analyze member data for quality improvement
- Educate members and providers about BH utilization processes