This position is fully remote.
Mon-Fri 8am-5pm EST preferably. Must have Ohio independent licensure LPCC or LISW, or RN with BH experience (or RN with compact licensure for OH).
Job Function Description
Function is responsible for care management, case management and utilization review of behavioral health and substance abuse services. Includes authorization, concurrent review, and coordination and assurance of appropriate levels of care to members. Provides care management services through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care. Employees in the professional and management levels within this function must have a valid clinical license and typically have a Master's degree in counseling, psychology or social work or are registered nurses (RN) with mental health specialty.
General Job Profile
- Generally work is self-directed and not prescribed.
- Works with less structured, more complex issues.
- Serves as a resource to others.
Job Scope and Guidelines
- Assesses and interprets customer needs and requirements.
- Identifies solutions to non-standard requests and problems.
- Solves moderately complex problems and/or conducts moderately complex analyses.
- Works with minimal guidance; seeks guidance on only the most complex tasks.
- Translates concepts into practice.
- Provides explanations and information to others on difficult issues.
- Coaches, provides feedback, and guides others.
- Acts as a resource for others with less experience.
Minimum Educational Background
- Undergraduate degree or equivalent experience.
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