Share Email Opening Title Utilization Review Clinician, Advocate, Virtual  EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.   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 not accepting applications. To search for an open position, please go to http://SocialWorkPRNInc.appone.com

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