Behavioral Health Utilization Manager

Community Health Choice

Houston, TX, USA

Full time

Healthcare / Insurance

Feb 24

This job is no longer accepting applications.

Behavioral Health Utilization Manager will assist the overall Behavioral Health Program for Community Health Choice in the review of telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines.


MINIMUM QUALIFICATIONS:


Education/Specialized Training/Licensure: Master's Degree

LCSW, LMFT, or LPC unrestricted Texas license


Work Experience :

Two (2) years' experience in an acute psychiatric care setting.

Two (2) years' experience in utilization review in a managed care environment with Medicaid and Medicare members.

 

Equipment Operated: Computer literate with knowledge of MS Word, MS Excel, Outlook, and telephone systems. Also able to navigate clinical platforms


SPECIAL REQUIREMENTS:


Communication Skills:

Above Average Verbal (Heavy Public Contact)

Writing /Composing (Correspondence / Reports )


Other Skills:

Analytical

Dictation/Transcription

Medical Terminology

Research

PC

MS Word

MS Excel


Advanced Education: Master's Degree Major: Social Work or related field


Work Schedule: Flexible


Other Requirements: Able to work independently under general instructions and working within a team environment. Ability to self manage while working remotely


 

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Community Health Choice

Community Health Choice is a local, non-profit health plan that offers affordable coverage to Texans.

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