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Care Review Clinician I

Our client is currently seeking a Care Review Clinician I -??LCSW, LPCC, LMFT

Remote with New Mexico license


The Job Responsibilities:



  • Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

  • Analyzes clinical service requests from members or providers against evidence based clinical guidelines

  • Conducts inpatient reviews to determine financial responsibility, prior authorization and other utilization

  • Requests additional information from members or providers in consistent and efficient manner



The Qualifications:



  • Master's Degree in Social Work, Psychology, or other Behavioral Health field

  • LCSW, LPCC or LMFT

  • Minimum years of experience: 3+ years Behavioral Health hospital acute care/medical experience

  • Current NM license


Please send your resume to Catherine Stenberg at Click Here to Email Your Resum? or call me at 678-987-9896.



Thank you

 

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