Behavioral Health Care Coordinator

• Ensuring accurate and timely clinical review of behavioral health cases for medical necessity
• Assisting members on the telephone
• Reviewing medical records
• Reviewing cases which involves contract interpretation of behavioral health diagnoses
• Utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits

• Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, RPsy) with current license to practice at the independent practice level
• Current clinical license in state of TX, OK, NM, MT or IL. and in good standings
• 3 years clinical experience (post licensure at the independent practice level) in psychiatric setting or own behavioral health practice
• Verbal and written communication skills
• Analytical and decision-making skills
• PC and database experience

Utilization review experience