Behavioral Health Care Coordinator
7 hours ago
Job Summary
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity, including assisting members on the telephone, reviewing medical records, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care.
Key Responsibilities:
- Conduct thorough clinical reviews of behavioral health cases to determine medical necessity
- Assist members on the telephone with their behavioral health needs
- Review medical records to ensure accurate and timely clinical information
- Utilize knowledge of medical necessity criteria to determine the level of care required for each case
Requirements:
- Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC) with current license to practice at the independent practice level
- Current clinical license in state of operations and in good standing
- 3 years clinical experience (post licensure at the independent practice level) in psychiatric setting or own behavioral health practice
- Verbal and written communication skills
- Analytical and decision-making skills
- PC and database experience
Preferred Requirements:
- Utilization review experience
Compensation:
The compensation for this position will vary depending on job-related skills, education, knowledge, and experience. This role aligns with an Annual Incentive Bonus plan.
Equal Opportunity Employer:
Health Care Service Corporation is an Equal Opportunity Employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued.
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