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

Social Work p.r.n.
Social Work p.r.n.
Verified Company
New York, United States

48 minutes ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
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.
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