Share Email Opening Title Utilization Review Clinician, Advocate, Remote  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, direct hire remote position. This role involves telephonic care review and authorization for prospective, concurrent, and discharge cases in psychiatric and substance use treatment facilities. You'll assess the appropriate level of care based on insurance medical necessity criteria, consult with treatment teams when criteria aren't met, and interact with Physician Advisors on clinical questions and treatment options. You will also provide information on mental health and substance use benefits and community resources to members and providers.   Position Requirements DE LSW with at least 5 years of combined experience in behavioral health or substance abuse treatment and Utilization Review/Care Management. Must demonstrate strong telephonic communication skills, the ability to influence and negotiate for patient care outcomes, and the capacity to meet strict deadlines. Proficiency in communication, relationship-building with providers, and familiarity with computer technology are essential.   This position is currently not accepting applications. To search for an open position, please go to http://SocialWorkPRNInc.appone.com

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