Clinician

• Perform clinical reviews and assess care related to mental health and substance abuse
• Monitor and determine whether levels of care and services are medically appropriate
• Evaluate member treatment before, during, and after services
• Perform prior authorization reviews according to regulatory guidelines and criteria
• Perform concurrent reviews of behavioral health inpatient care
• Analyze behavioral health member data to improve quality and appropriate utilization
• Educate providers, members, and families regarding the behavioral health utilization process
• Discuss levels of care and services with behavioral health healthcare providers
• Collaborate with medical directors and leadership to improve care quality and efficiency
• Formulate and present cases in staffing and integrated rounds
• Comply with policies and standards
• Perform other assigned duties

Clinician jobs in Washington

Utilization Review Clinician – Behavioral Health