Psychotherapist- Behavioral Health Utilization Review

Psychotherapist
- Behavioral Health Utilization Review

Location:

Menomonee Falls, Wisconsin – Froedtert Menomonee Falls Hospital facility.

Full‑time equivalent: 0.6.

Standard hours: 24.00 per week.

Shift: Monday/Wednesday/Friday, 8:00 am – 4:30 pm. No holidays or weekends.

Job summary:

The Psychotherapist‑Behavioral Health Utilization Review is a member of the Behavioral Health team responsible for establishing and documenting medical necessity for recommended patient services, supporting patients in accessing care, and acting as department liaison with revenue stakeholders. The role collaborates with all team members throughout the patient journey—including referral and work queue management, clinical pre‑screenings, benefit verification, registration, scheduling, and submission of behavioral health prior authorizations, concurrent reviews, and discharge clinics.

It works closely with patient financial services, billing, pre‑registration, managed care, and credentialing to handle insurance denials and appeals, participates in department QA activities, and supports direct clinic care roles as needed.

Experience required:

• 3,000 hours of post‑graduate clinical supervision.
• Care coordination for behavioral health patients.
• Prior knowledge/experience with behavioral health hospital billing, pre‑authorization, or insurance verification.
• Demonstrated knowledge of Medicare, Medicaid, HMOs, and PPOs (preferred).

Education required:

• Master’s degree in social work, counseling, educational psychology, or an allied health profession from an accredited institution.
• Master’s degree in clinical mental or behavioral health discipline with a clinic field placement/practicum (preferred).

Training required:

• Specific clinical training in psychotherapy, psychiatric evaluation, and assessment.
• Treatment for substance use disorders and training in one or more modalities (CBT, DBT, ACT, etc.) (preferred).

Special skills:

• Understanding of the DSM.
• Exceptional customer relations skills.
• Knowledge of ASAM level‑of‑care criteria and behavioral health billing/coding (preferred).
• Familiarity with online insurance eligibility systems (preferred).
• Excellent typing and computer skills (preferred).
• Knowledge of medical terminology (preferred).
• Ability to organize work efficiently and maintain high accuracy and productivity (preferred).

Licensure:

• Current Wisconsin licensure as Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC).
• Substance Counselor certification (CSAC, SAC) (preferred).

Benefits and perks at Froedtert Health:

• Paid time off.
• Growth opportunity:
  Career Pathways & Career Tuition Assistance, CEU opportunities.
• Academic partnership with the Medical College of Wisconsin.
• Referral bonuses.
• Retirement plan – 403(b).
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics.
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance.
• Discounts on gym memberships, travel, and other work‑life benefits.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages, and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262‑439‑1961. We maintain a drug‑free workplace and perform pre‑employment substance abuse testing. If you have a need that requires an accommodation, please contact us at 262‑439‑1961.

We will attempt to fulfill all reasonable accommodation requests.