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    Utilization Review Clinician, Advocate, Virtual - New York, United States - Social Work p.r.n.

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    Description
    Utilization Review Clinician/Advocate needed for full-time, permanent, remote position.


    Position Responsibilities:

    • Performs telephonic care review and authorization determinations for prospective, concurrent and discharge review with psychiatric and substance use treatment facilities as assigned.
    • Determines appropriate level of care related to mental health and substance use treatment for members based on insurance medical necessity level of care criteria.
    • Consults with treatment team when requests for services do not meet medical necessity criteria.
    • Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases.
    • Provides information to members and providers regarding mental health and substance use benefits and community treatment resources.

    Annual Salary:
    $60,000.


    Position Requirements

    LMSW and minimum of 5 years combined experience in direct care in behavioral health and/or substance abuse treatment settings and Utilization Review/ Care Management experience.

    Can be licensed in any state.


    This position is currently accepting applications.


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