Job Title: Telecommuter Behavioral Health Review Specialist
This is a telecommuter role based in Albuquerque, Chicago, Richardson, and Tulsa headquarters.
Position Details:
Part-Time, Exempt status - 32 hours/week
Evenings and weekends schedule
Work Schedule:
One 8-hour shift on Friday nights from 12:30 am to 8:30 am (Saturday morning)
Two 12-hour shifts on Saturday and Sunday nights from 8:30 pm to 8:30 am
Must Have: At least 3 years of clinical experience post-licensure at the independent practice level in a psychiatric setting/outpatient facility, or own behavioral health practice.
Job Summary
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. Responsibilities include assisting members via telephone, reviewing medical records, interpreting behavioral health diagnoses, and applying knowledge of medical necessity criteria across all levels of behavioral health care, from outpatient visits to inpatient care.
Job Requirements
Registered Nurse (RN) with current license or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, RPsy) with a current license to practice independently.
Current clinical license in the state of operation, in good standing.
At least 3 years of clinical experience in a psychiatric setting or own behavioral health practice.
Strong verbal and written communication skills.
Analytical and decision-making skills.
Experience with PC and database management.
Preferred Job Requirements
Utilization review experience.
Additional Notes:
Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.