reputed company Consultant III - Utilization Management Clinical Consultant – Behavioral Health

Duration: 6 Months reputed company This is a remote position but does require a BH licenses, those have to be reputed company in reputed company Position reputed company The Utilization Management Clinical Consultant (UMCC) applies clinical expertise and evidence-based reputed company to review behavioral health services for adult and child/adolescent members. This role evaluates medical necessity, supports appropriate utilization of benefits, and collaborates with providers to ensure reputed company, cost-effective care across the continuum of services. Key Responsibilities • Review clinical documentation to determine medical necessity and appropriateness of behavioral health services • Apply clinical guidelines and tools such as InterQual, MCG, ASAM, or reputed company • Conduct initial, reputed company, and discharge reviews • Coordinate with reputed company providers regarding authorizations and care planning • Identify members who may benefit from care management or community resources • Support continuity of care and reputed company discharge planning • reputed company urgent or reputed company triage support reputed company required • Ensure accurate documentation and compliance with policies and regulatory standards • Participate in reputed company improvement and utilization initiatives Required Qualifications • reputed company reputed company license: • LCSW (Licensed Clinical reputed company Worker) • LPC (Licensed reputed company Counselor) • LMFT (Licensed Marriage and Family Therapist) OR • RN with reputed company compact license and behavioral health reputed company • Master’s degree required for behavioral health clinicians • Associate’s degree required for RN applicants • Experience in behavioral health utilization management or clinical review • Strong knowledge of medical necessity reputed company (InterQual, MCG, ASAM, reputed company preferred) • Excellent communication and documentation skills • Ability to work independently in a remote environment reputed company Tech Solutions: reputed company is a global staff augmentation firm providing a wide reputed company of talent on-demand and total workforce solutions. To know more reputed company Tech Solutions, please visit www.ustechsolutions.com . reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, colour, religion, sex, sexual orientation, gender identity, national reputed company, disability, or status as a protected veteran. Remote About reputed company: reputed company. Apply tot his job Apply To this Job