Clinical Case Manager Behavioral Health FT, Day
4 months ago
Inspire health. Serve with compassion. Be the difference.
Job Summary
Performs systematic reviews of clinical documentation establishing medical necessity and obtaining authorization for treatment from third party payors. Documents utilization review process and provides communication to treatment team or other parties as needed.Serves as an additional clinical resource for the department as directed by the manager. Provides direct and indirect counseling services to patients and their families using individual, group, and family therapy. Provides bio-psychosocial assessments, risk assessments, treatment planning and coordination with multidisciplinary team. Remains open to clinical and peer supervision process.
Accountabilities
Conducts comprehensive review of clinical information gleaned from medical records, referral sources, treatment team, etc. to communicate with and obtain authorization from third party payers. 50%
Records authorization numbers and other utilization review data into EPIC (EMR) - 15%
Obtains benefit profile for patient coverage including active plan coverage and deductibles. 10%
Generates appeals for denials of authorization and coverage 10%
Maintains log of current in network payers to inform decision making for admissions and discharges- 10%
Serve as an additional resource for the department including any clinical or administrative duties as requested by the manager. 5%
Supervisory/Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Hiring Requirements
Master's degree in social work or counseling
2 years professional experience in a behavioral health setting preferred
In lieu of
In lieu of a Master's degree in social work or counseling, will accept an AD N, BSN or MSN in Nursing
Work Shift
Day (United States of America)Location
Baptist Gracern RdFacility
1502 Behavioral CareDepartment
15026601 Behavioral Care Day TreatmentShare your talent with us Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
-
Clinical Case Manager Behavioral Health FT Day
4 weeks ago
Columbia, South Carolina, United States Prisma Health Full timeTransforming Healthcare TogetherWe are seeking a skilled Clinical Case Manager to join our Behavioral Health team at Prisma Health. As a key member of our team, you will play a vital role in inspiring health and serving with compassion.Job SummaryThe Clinical Case Manager will perform systematic reviews of clinical documentation to establish medical...
-
Clinical Liaison for Behavioral Health
4 weeks ago
Columbia, South Carolina, United States Centene Corporation Full timeJob SummaryWe are seeking a highly skilled Clinical Liaison to join our Medical Management/Health Services team. As a clinical professional, you will play a critical role in serving as a liaison for external groups and providers regarding clinical information.Key Responsibilities:Assess and review member clinical records and services related to behavioral...
-
Behavioral Health Specialist
4 weeks ago
Columbia, South Carolina, United States Surpass Behavioral Health Full timeJob SummarySurpass Behavioral Health is seeking a compassionate Board Certified Behavioral Analyst to join our team as a Behavioral Health Specialist. In this role, you will work with children and teens with autism spectrum disorders (ASD) in a multidisciplinary team setting. Your expertise will be utilized to develop and implement individualized programming...
-
Occupational Health Case Manager
4 weeks ago
Columbia, South Carolina, United States JES Tech Full timeJob SummaryJES Tech is seeking a highly skilled Nurse Case Manager to join our team. As a key member of the Legacy Health Program, you will be responsible for facilitating and coordinating clinical case management services to prevent unnecessary disability related to injury, illness, and hazardous exposures at the Hanford Site.ResponsibilitiesCollaborate...
-
Occupational Health Case Manager
3 weeks ago
Columbia, South Carolina, United States JES Tech Full timeJob Title: Legacy Health Case ManagerJES Tech is seeking a skilled Legacy Health Case Manager to join our team. This role is responsible for facilitating and coordinating clinical case management services to prevent unnecessary disability related to injury, illness, and hazardous exposures at the Hanford Site.Key Responsibilities:Collaborate with clinic...
-
West Columbia, South Carolina, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary As a key member of the Family Medicine Department, the Behavioral Health Program Coordinator plays a vital role in supporting the department manager in all phases of management. This includes planning, organizing, coordinating, monitoring, training, and implementing effective work...
-
Behavior Therapist
4 weeks ago
Columbia, South Carolina, United States Surpass Behavioral Health Full timeBehavior Therapist Opportunity at Surpass Behavioral HealthSurpass Behavioral Health is seeking a dedicated and compassionate Behavior Therapist to join our team. As a Behavior Therapist, you will work closely with our Board Certified Behavior Analysts to provide individualized therapy services to children with autism in a clinical setting.Key...
-
Behavioral Health Specialist
4 weeks ago
West Columbia, South Carolina, United States Surpass Behavioral Health Full timeJob Title: Board Certified Behavior Analyst, BCBA, Part-TimeAbout the Role:We are seeking a highly skilled Board Certified Behavior Analyst (BCBA) to join our team at Surpass Behavioral Health. As a BCBA, you will play a critical role in providing high-quality Applied Behavior Analysis (ABA) therapy for children and teens with autism.Key...
-
Behavior Therapist
4 weeks ago
Columbia, South Carolina, United States Surpass Behavioral Health Full timeAbout the RoleAt Surpass Behavioral Health, we are dedicated to providing high-quality Applied Behavior Analysis (ABA) therapy for children and teens with autism. We are seeking a compassionate and skilled Behavioral Technician to join our team.Key ResponsibilitiesProvide direct one-on-one therapeutic care to clients in a home, school, clinic, and/or...
-
RBT/Behavior Technician
3 months ago
Columbia, United States Autism Behavioral Institute Full timeWe are seeking highly motivated individuals with a passion and desire to make a difference in the life of children with autism in Columbia, South Carolina. Services may be provided in clinic or home-based settings. Responsibilities: * Provide home-based services for children with Autism Spectrum Disorder * Introduces safe and appropriate replacement...
-
Clinical Education Specialist
2 weeks ago
Columbia, United States Johns Hopkins Medicine Full timeJob DescriptionJob DescriptionJohns Hopkins Howard County Medical Center, located in Columbia, Maryland combines the convenience of a full range of hospital and wellness services, more than 1000 affiliated doctors in nearly 100 clinical specialties, award winning clinical excellence and membership in Johns Hopkins Medicine, one of the country’s premier...
-
RN Care Manager
4 weeks ago
Columbia, South Carolina, United States Providence St. Joseph Health Full timeJob SummaryAs a RN Care Manager, you will provide clinically-based case management to support the delivery of efficient patient care. You will have the overall accountability for the integrated responsibilities of case management, utilization management, discharge planning, facilitation and coordination of care.Key ResponsibilitiesCollaborate with other...
-
Columbia, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryProvides screening, assessment, planning, problem resolution, resource management, counseling, and crisis intervention as they relate to the health care and discharge planning needs of the patient/family in the Emergency Department (ED). The Licensed Master Social Worker functions as a key...
-
Columbia, United States HUMANIM INC Full timeReporting to the Behavioral Health Program Manager, this role will be responsible for the full case management of the assigned caseload and coordination of appropriate services for clients. This position provides individualized teaching, training, and support needed to adults with severe and persistent mental illnesses to help them maintain their...
-
Behavioral Health Crisis Specialist
3 weeks ago
Columbia, Missouri, United States Burrell Behavioral Health Full timeCrisis Services OverviewBurrell Behavioral Health is seeking a skilled Crisis Services Specialist to join our team. As a Crisis Services Specialist, you will provide critical support to individuals experiencing mental health crises.Key ResponsibilitiesConduct face-to-face crisis assessments and telephone crisis interventions as needed.Communicate with other...
-
Behavior Technician
3 weeks ago
Columbia, United States Autism Behavioral Institute Full timeAlready Autism Health is dedicated to creating a supportive and nurturing environment for children on the autism spectrum disorder (ASD). We believe in fostering growth, learning, and development through individualized support and tailored programs. We are seeking to hire a compassionate and dedicated Behavioral Technician. What we offer for qualified...
-
Registered Nurse Case Manager
2 weeks ago
Columbia, United States US Tech Solutions, Inc. Full timeJob Description: Monday through Friday, 8:30 am -5:00 pm. Two late shifts until 8:00 pm per month, 11:30 am - 8:00 pm, no late shifts on Fridays Contract only Onsite training at our Percival Road office in Columbia SC for the first week. At the end of the week, they will be deployed home with equipment and will work remotely Must be within 2 hours of the...
-
Nurse Case Manager
4 weeks ago
Columbia, South Carolina, United States JES Tech Full timeJob Title: Nurse Case ManagerWe are seeking a highly skilled and experienced Nurse Case Manager to join our team at JES Tech. As a key member of our Legacy Health Case Management Program, you will play a critical role in facilitating and coordinating clinical case management services to prevent unnecessary disability related to injury, illness, and hazardous...
-
Registered Behavior Technician, RBT
4 weeks ago
Columbia, United States Surpass Behavioral Health Full timeJob DescriptionAt Surpass Behavioral Health, we provide high-quality Applied Behavior Analysis (ABA) therapy for children and teens with autism. Our dedicated team is passionate about making a positive impact in the lives of our clients and their families. Join our team as a Registered Behavior Technician to be a part of our mission to make a difference. ...
-
Registered Behavior Technician, RBT
4 weeks ago
Columbia, United States Surpass Behavioral Health Full timeAt Surpass Behavioral Health, we provide high-quality Applied Behavior Analysis (ABA) therapy for children and teens with autism. Our dedicated team is passionate about making a positive impact in the lives of our clients and their families. Join our team as a Registered Behavior Technician to be a part of our mission to make a difference. Our Registered...