Utilization Review Clinician - Behavioral Health
About this role
Utilization Review Clinician - Behavioral Health
Description
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Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.
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Key Details
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Centene is seeking a remote Utilization Review Clinician – Behavioral Health to support our inpatient and outpatient Behavioral Health Medicare Plan. In this role, you will perform medical necessity reviews and authorization determinations to help ensure members receive appropriate, high-quality behavioral health services. Behavioral health and/or utilization management experience is preferred, along with strong knowledge of medical necessity criteria and managed care principles.
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