Behavioral Health Utilization Management Care Coordinator

Location
Norfolk, VA
Salary
Competitive
Posted
Aug 08, 2019
Closes
Oct 26, 2019
Ref
127408BR
Function
Management
Industry
Healthcare
Hours
Full Time
Behavioral Health Utilization Management Care Coord is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, BH and ARTS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment.

Qualifications

Education Level
Master's Level Degree - COUNSELING OR
Master's Level Degree - SOCIAL WORK OR
RN-Bachelor's Level Degree

Experience
Required: Clinical - 2 years

Preferred: Case Management - 1 year

License
Required: License Clinical Social Worker, License Professional Counselor, Registered Nurse

Preferred: None, unless noted in the "Other" section below

Skills
Required:

Preferred: None, unless noted in the "Other" section below

Other
2 years experience working in behavioral health and 1 years' experience with behavioral health care coordination, discharge planning, continuity of care or transitions of care required. LCSW or LPC or LMFT or RN current license for the state of Virginia. LMHP- S, LMHP-R may be considered if actively working towards licensure and prior experience is present

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