Care Coordination Specialist
3 days ago
About the Role:
Community Behavioral Health (CBH) is seeking a skilled Care Coordination Specialist to join our team. As a key member of our care management team, you will be responsible for coordinating care and services for our members, ensuring they receive timely access to quality, medically necessary behavioral health services.
Key Responsibilities:
- Conduct utilization management activities, including interagency meetings, social determinants interviews, treatment team meetings, case consultations, care coordination, provider meetings, reviews, and treatment linkage.
- Authorizing treatment when Medical Necessity Criteria are met, consulting with Physician Advisor, Psychologist Advisor, and Clinical Leadership as clinically appropriate.
- Generate denial letters based on physician reviews and in accordance with state regulations as needed.
- Facilitate care coordination with system partners, addressing social determinants, barriers to wellness, and other needs of members, including connection to appropriate community-based services.
- Demonstrate an understanding of Evidence-Based Practices (EBPs) and connect members to appropriate evidence-based treatment at admission, during treatment, and at discharge.
Requirements:
- Master's degree in Social Work or related field
- Clinical Licensure: Qualified candidates are required to obtain license within the first 18 months (1.5 years) of employment; PA Child Abuse Clearance required
- Required Licensure: Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW)
- Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults, children, adolescents, and/or their families in behavioral health settings and experience in assessment and treatment planning; and/or experience in a managed care setting
Salary: $65,000 - $85,000 per year, depending on experience.
Work Conditions:
- Must be able to travel within Philadelphia and surrounding counties.
- Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling, and/or repetitive wrist/hand movements for various lengths of time throughout the day.
Location: This position is located in Philadelphia, PA.
Equal Employment Opportunity: Community Behavioral Health is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals.
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