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Licensed Utilization Review Specialist

L5

virtual vocationsNew York, NY3 days ago

Occupations

Mental Health and Substance Abuse Social WorkersMental Health CounselorsTherapists, All Other

Industries

Outpatient Mental Health and Substance Abuse CentersOffices of Physicians, Mental Health SpecialistsAll Other Outpatient Care Centers
As a key member of the team, the Licensed Utilization Review Specialist will work remotely in a full-time capacity, ensuring clinically appropriate care and cost-effective utilization of services through ongoing clinical review of patients from admission to discharge.
Key Responsibilities: Apply utilization criteria to monitor appropriateness of admissions and continued stay reviews Communicate with third-party payers for initial and concurrent clinical reviews Document actions and ensure patient charts meet medical necessity criteriaRequired QualificationsMaster's Degree in Social Sciences or equivalent experience required Active substance abuse or mental health licensure in the relevant state At least 1 year of experience in a relevant field Ability to exercise discretion and independent judgment in job performance In-depth knowledge of disease processes, medical terminology, and utilization review
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Apply now (opens in a new tab)

Level

SeniorL5

Location

New York, NY

Occupation

Mental Health and Substance Abuse Social Workers

Industry

Outpatient Mental Health and Substance Abuse Centers

Posted

3 days ago

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