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Massachusetts Licensed Behavioral Health Reviewer
Job in
Newark, Essex County, New Jersey, 07175, USA
Listed on 2026-03-05
Listing for:
Virtual Vocations Inc
Full Time
position Listed on 2026-03-05
Job specializations:
-
Healthcare
Healthcare Nursing, Healthcare Administration
Job Description & How to Apply Below
Key Responsibilities Conduct benefit coverage reviews and utilization management according to regulatory guidelines Collaborate with Behavioral Health leadership to improve service and reduce administrative costs Review prior authorization requests and ensure compliance with organizational standards
Required Qualifications Current unrestricted Massachusetts license in a behavioral health area of practice
Minimum education:
BS Nursing; LICSW, LMHC, or equivalent behavioral health qualification Direct practice clinical experience in the area of credential and knowledge of utilization management principles Health Plan experience performing utilization review activities
Experience with McKesson's Inter Qual Clinical Screening Criteria preferred
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