Florida Licensed Care Review Clinician

Providing support for member clinical service review processes, the full-time Florida Licensed Care Review Clinician will assess behavioral health services for medical necessity, analyze clinical requests against guidelines, and collaborate with multidisciplinary teams in a remote environment. Key responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze clinical service requests against evidence-based guidelines and determine prior authorization needs Collaborate with teams to promote care models and may approve requests for behavioral health therapy services Required qualifications At least 2 years of healthcare experience, including behavioral health or hospital acute care Active and unrestricted licensure as an LCSW, LMSW, LPC, LPCC, or LMFT in Florida Demonstrated knowledge of community resources and ability to work with diverse populations Proven ability to work independently and manage multiple projects effectively Proficiency in Microsoft Office and applicable software programs