Clinical Case Manager Behavioral Health FT, Day
3 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
2 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...
-
Case Manager RN FT Days
4 weeks ago
Columbia, South Carolina, United States Piedmont Medical Center Full timeJob Title: Case Manager RN FT DaysPiedmont Medical Center is seeking a skilled Case Manager RN FT Days to join our team. As a Case Manager RN FT Days, you will be responsible for coordinating the daily activities of the case management team, while overseeing the clinical plan of care to conform with evidence-based practice and/or regulatory/payor...
-
Behavioral Health Case Manager II
3 weeks ago
Columbia, Missouri, United States Elevance Health Full timeJob Title: Behavioral Health Case Manager IIJob Summary:Elevance Health is seeking a highly skilled Behavioral Health Case Manager II to join our team. As a Behavioral Health Case Manager II, you will be responsible for providing case management services to members with behavioral health and substance abuse needs. This is a remote position that requires...
-
Clinical Case Manager
4 weeks ago
Columbia, Missouri, United States US Tech Solutions Full timeJob Title: Clinical Case ManagerJob Summary:We are seeking a highly skilled Clinical Case Manager to join our team at US Tech Solutions. As a Clinical Case Manager, you will be responsible for providing telephonic case management services to our members, working closely with healthcare providers and patient representatives to ensure high-quality patient...
-
Clinical Case Manager
4 weeks ago
Columbia, South Carolina, United States Experis Full timeJob SummaryThe Clinical Case Manager will be responsible for reviewing and evaluating medical or behavioral eligibility for benefits and applying clinical expertise, administrative policies, and established clinical criteria to service requests.Key Responsibilities:Active Case Management (60%): Provide case management services by assessing member needs,...
-
Clinical Liaison for Behavioral Health
1 week 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
1 week 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...
-
Clinical Case Manager
3 weeks ago
Columbia, South Carolina, United States US Tech Solutions Full timeJob Description:We are seeking a highly skilled Registered Nurse to join our team as a Case Manager. As a Case Manager, you will be responsible for providing telephonic case management services to our members, working closely with healthcare providers and other stakeholders to ensure high-quality care.Responsibilities:Reviews and evaluates medical or...
-
Clinical Case Manager
2 weeks ago
Columbia, South Carolina, United States Experis Full timeJob Title: Clinical Case ManagerLocation: RemoteJob Type: Full-TimeJob Description:We are seeking a dedicated Clinical Case Manager to support members by assessing and coordinating medical and behavioral healthcare services. The ideal candidate will apply their clinical expertise to review eligibility for benefits and ensure quality, cost-effective outcomes...
-
Occupational Health Case Manager
1 week 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
4 days 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...
-
West Columbia, South Carolina, United States Prisma Health Full timeTransforming Healthcare TogetherJob SummaryAs a key member of our Family Medicine team, the Behavioral Health Program Coordinator will play a vital role in supporting the department manager in all phases of management. This includes planning, organizing, coordinating, monitoring, training, and implementing effective work processes and programming. The...
-
Behavior Therapist
2 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
1 week 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
2 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...
-
Clinical Behavioral Therapist II
2 months ago
Columbia, South Carolina, United States Prisma Health Full timeEmpower individuals. Foster healing. Make an impact.Position OverviewThe role involves delivering both direct and indirect therapeutic services to clients and their families through various modalities, including individual, group, and family therapy. Responsibilities include conducting comprehensive bio-psychosocial evaluations, assessing risks, and...
-
Clinical Behavioral Therapist II
2 months ago
Columbia, South Carolina, United States Prisma Health Full timeEmpower individuals. Show empathy. Make a meaningful impact.Position OverviewThe role involves delivering both direct and indirect therapeutic services to clients and their families through individual, group, and family counseling. This includes conducting comprehensive bio-psychosocial evaluations, risk assessments, and formulating treatment plans in...
-
RBT/Behavior Technician
2 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...
-
Clinic Nurse
4 weeks ago
Columbia, United States Burrell Behavioral Health Full timeJob Description:Job Title: Licensed Practical Nurse (LPN) - TelephoneLocation: Remote - MISSOURI RESIDENTS ONLYDepartment: Burrell Behavioral HealthEmployment Type: Full TimeShift: Monday - FridayJob Summary:Are you a passionate and dedicated Licensed Practical Nurse (LPN) looking to make a positive impact in the lives of clients in a virtual care setting?...