Minnesota Licensed Clinical Reviewer - job 1 of 3

Job Summary

A company is looking for a Clinical Reviewer - Licensed Behavioral Health (Substance Abuse) - Part-time (Remote U.S.).

Key Responsibilities

• Review and interpret patient records against ASAM criteria to determine medical necessity and appropriateness of care
• Ensure accuracy and timeliness of review cases within contract requirements and assess daily workload
• Function as a liaison for provider customer service issues and maintain current knowledge related to review processes

Required Qualifications

• Active, unrestricted license in Minnesota as LPCC, LMFT, or LICSW, or eligibility to obtain within six months
• 3+ years of direct clinical work experience as a mental health professional
• 1+ years of experience in Utilization Review, Utilization Management, or Prior Authorization
• In-depth understanding of ASAM criteria and familiarity with medical records structure and terminology
• Strong clinical assessment capabilities and proficiency in medical record abstraction