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 potential quality of care or service concerns to leadership.
What's Needed?
- Minimum of 3 years of relevant Behavioral Health Utilization Management experience.
- Active, unrestricted Idaho license as a Registered Nurse (RN) or Social Worker.
- Strong knowledge of utilization management processes and review criteria.
- Ability to interpret member benefits, provider contracts, and coverage guidelines.
- Excellent clinical judgment, decision-making, and communication skills.
What's in it for me?
- Opportunity to work in a dynamic healthcare environment dedicated to improving patient outcomes.
- Engage in meaningful work that makes a difference in members' lives.
- Collaborate with a supportive team of healthcare professionals.
- Develop your skills and advance your career in behavioral health management.
- Work in a location that values diversity and inclusion, fostering a welcoming workplace culture.
Upon completion of waiting period associates are eligible for:
- Medical and Prescription Drug Plans
- Dental Plan
- Supplemental Life Insurance
- Short Term Disability Insurance
- 401(k)
If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you!
About ManpowerGroup, Parent Company of: Manpower, Experis, Talent Solutions, and Jefferson Wells.
Manpower® is a global leader in contingent staffing and permanent resourcing, providing companies with strategic and operational flexibility and creating talent at scale. Our specialized recruiting teams assess and guide talent into meaningful, sustainable employment, while our PowerSuite technology enables deeper insight and smarter matching, helping candidates find opportunities that align with their strengths, experience, and career goals.
In this constantly shifting world, our flexible workforce solutions provide companies with the business agility needed to succeed. Manpower is part of the ManpowerGroup® (NYSE: MAN) family of brands, which also includes Experis, Talent Solutions and Jefferson Wells. For more information about Manpower, follow us on LinkedIn, Facebook, X and Instagram.
