Job Summary:
We are seeking a dedicated and experienced Behavioral Health Manager to join our team. The Behavioral Health (BH) Care Management Coordinator primary responsibility is to evaluate a member’s Behavioral Health conditions through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient’s services based on advanced knowledge and independent analysis of those medical records and application of appropriate medical necessity criteria. If necessary, the BH Care Management Coordinator directly interact with providers to obtain additional BH information. The BH Care Management Coordinator has the authority to commit the company financially by independently authorizing services determined to be medically necessary based on their personal review. For those cases that do not meet established criteria, the BH Care Management Coordinator provides relevant information regarding members BH condition to the Medical Director for their further review and evaluation. The BH Care Management Coordinator has the authority to approve but cannot deny the care for patients. The BH Care Management Coordinator is also responsible for maintaining regulatory compliance with federal, state and accreditation regulations. Additionally, the BH Care Management Coordinator acts a patient advocate and a resource for members when accessing and navigating the behavioral health care system.

Job Types: Full-time, Contract

Pay: $32.00 - $38.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Healthcare setting:

• Telehealth

Medical specialties:

• Addiction Medicine
• Psychiatry

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Master's (Required)

Experience:

• Behavioral/Mental Health: 3 years (Required)
• Utilization review: 1 year (Preferred)

License/Certification:

• Licensed Clinical Social Worker (Required)
• LMFT (Required)
• LPC (Required)

Work Location: Remote