Behavioral Health Clinician

Job Description Job SummaryThe Behavioral Health Clinical Reviewer is responsible for conducting administrative and process-based reviews of medical records to ensure compliance with medical necessity criteria, regulatory guidelines, and contractual requirements. This role evaluates behavioral health services for accuracy, appropriateness, and completeness. This is a non-direct care position requiring strong clinical expertise in behavioral health.Key ResponsibilitiesConduct prospective, concurrent, and retrospective reviews of behavioral health servicesEvaluate medical records to determine medical necessity and adherence to established guidelinesEnsure accuracy, quality, and timeliness of all reviewsManage daily workload and review queues to meet productivity standardsCollaborate with internal teams on quality improvement initiativesServe as a liaison for providers, addressing inquiries and resolving service-related issuesMaintain current knowledge of behavioral health practices, policies, and review criteriaParticipate in team meetings and ongoing trainingEnsure compliance with HIPAA and all organizational policiesRequired QualificationsActive, unrestricted Arkansas license in good standing in one of the following:LCSW, LMSWLAMFT, LMFTLAC, LPCLPE, LPE-IMaster's degree in Behavioral Health or a related field from an accredited institutionMinimum of 2+ years of experience in a behavioral health setting, including utilization review or case managementStrong knowledge of medical, psychiatric, and psychological terminologyExperience reviewing mental health assessments and treatment plansUnderstanding of behavioral health services across inpatient and outpatient settingsAbility to handle confidential HIPAA information with discretionStrong interpersonal, organizational, and communication skillsAbility to collaborate effectively with providers and stakeholdersPreferred QualificationsExperience working with child and adolescent populationsExperience in Utilization Review (UR) or Utilization Management (UM)Clinical quality review and medical record evaluation experienceFamiliarity with Arkansas Medicaid medical necessity criteriaKnowledge of Arkansas Medicaid behavioral health policies and proceduresProficiency with automated review systems and Microsoft Office SuiteProper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!AC