Washington State Licensed Utilization Specialist

A company is looking for a Care Review Clinician II. Key Responsibilities Process concurrent reviews and prior authorizations for healthcare members Assess services for optimal outcomes and compliance with regulations Collaborate with internal teams to enhance continuity of care Required Qualifications Licensed in Washington State (WA) as a Social Worker, Mental Health Counselor, Marriage Family Therapist, or Psychiatric Nurse 2-4 years of clinical practice experience, preferably in hospital nursing or utilization management Proficient in Interqual, NCQA, and state/federal regulations Proficient in Microsoft Office Suite and relevant computer applications Adhere to HIPAA guidelines and maintain confidentiality

Apr 18, 2025 - 12:37

A company is looking for a Care Review Clinician II. Key Responsibilities Process concurrent reviews and prior authorizations for healthcare members Assess services for optimal outcomes and compliance with regulations Collaborate with internal teams to enhance continuity of care Required Qualifications Licensed in Washington State (WA) as a Social Worker, Mental Health Counselor, Marriage Family Therapist, or Psychiatric Nurse 2-4 years of clinical practice experience, preferably in hospital nursing or utilization management Proficient in Interqual, NCQA, and state/federal regulations Proficient in Microsoft Office Suite and relevant computer applications Adhere to HIPAA guidelines and maintain confidentiality