Behavioral Health Utilization Manager
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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.
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
Above Average Verbal (Heavy Public Contact)
Writing /Composing (Correspondence / Reports )
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 is a local, non-profit health plan that offers affordable coverage to Texans.