1 jobs found in Meridian, ID

Our client, a leading healthcare organization, is seeking a Clinical Reviewer I – Behavioral Health to join their team. As a Clinical Reviewer I – Behavioral Health, you will be part of the Behavioral Health Utilization Management department supporting healthcare quality and member satisfaction. The ideal candidate will have strong clinical judgment, excellent communication skills, and the ability to work independently, which will align successfully in the organization. Job Title: Clinical Reviewer I – Behavioral Health Location: Meridian, ID Pay Range: $42.23 an hour What's the Job? Perform utilization management reviews for selected behavioral health services. Make clinical determinations based on established policies, procedures, and review criteria. Determine member eligibility and benefit coverage according to contracts. Respond to requests for authorization of medications, inpatient procedures, and services. Identify, document, and report...