Utilization Management - Behavioral Health - Outpatient

Become a part of our caring community The Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Key Responsibilities: Clinical Review : • Conduct comprehensive clinical reviews of prior authorization requests for behavioral health services to determine medical necessity. • Apply advanced evidence-based clinical guidelines in review decisions. • Ensure compliance with accreditation, state, and federal regulations.…