Behavioral Health Specialist
4 weeks ago
The Behavioral Health Clinical Specialist is a key member of our behavioral health team, responsible for ensuring the appropriate utilization of behavioral health services for our members. This licensed clinician will be instrumental in upholding the highest standards of care and efficiency.
Key Responsibilities:
Conduct utilization management activities, assess, certify, and refer members for behavioral health services. Communicate with members, providers, and internal stakeholders to gather necessary information for utilization review decisions. Monitor members' progress throughout treatment, conducting ongoing reviews to assess effectiveness and make recommendations for adjustments as needed. Document all utilization review activities accurately and thoroughly, maintaining compliance with regulatory requirements and health insurance company policies.
Qualifications:
Ability to review mental health and substance abuse cases rapidly and effectively. Skilled in problem-solving and critical thinking. Excellent communication, interpersonal, and organizational skills. Ability to work independently and collaboratively in a fast-paced environment with competing priorities. Proficiency with Microsoft applications. Successful completion of Health Care Sanctions background check. Ability to converse and write fluently in English.
Education/Experience:
Master's degree in a mental health field. Active, unrestricted license to practice as a mental health professional in the State of Oklahoma. At least four years of related clinical experience in mental health. Managed behavioral health and/or utilization review experience preferred.
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