Massachusetts Licensed Clinical Reviewer in Anchorage, AK

A company is looking for a Clinical Reviewer (Inpatient) in Behavioral Health. Key Responsibilities Conduct benefit coverage reviews and utilization management according to regulatory guidelines Collaborate with Behavioral Health leadership and other staff to improve service and reduce costs Review prior authorization requests and determine medical necessity for behavioral health services Required Qualifications Current unrestricted Massachusetts license in a behavioral health area of practice Minimum education : BS Nursing; LICSW, LMHC, or other independent behavioral health qualification Direct practice clinical experience in the area of credential with knowledge of utilization management principles Health Plan experience performing utilization review activities Experience with McKesson's InterQual Clinical Screening Criteria preferred