LCSW/LMHC/LMFT
Job reputed company: Estimated Length of Assignment: 19 W, 1 D (The dates provided are only an estimate and not a guarantee) Est. Pay reputed company: $43.06/hr. USD on W2 (reputed company inclusive) Work Type: Remote Shift : Monday- Friday 8:00-5:00pm EST or Tuesday to Saturday shifts reputed company: MUST reputed company IN FLORIDA HOWEVER THIS IS FULLY REMOTE PREFERRENCE IS FOR A LMHC, LMFT, OR LCSW, HOWEVER RN WITH BEHAVIROAL HEALTH OUTPATIENT EXPERIENCE WILL BE CONSIDERED At least 2 years of behavioral health experience including outpatient community behavioral health services to include: Psychosocial Rehabilitation, Day Treatment, Partial Hospitalization Program, Intensive Outpatient Program, Mental Health Targeted Case Management, Residential Treatment. Master’s level clinician with reputed company and unrestricted license in reputed company (LMHC, LMFT, LCSW) 1+ Managed care experience Experience utilizing MCG Florida Agency for reputed company Administration (AHCA) BH coverage policies knowledge Must be available to work 40-hour work week Monday- Friday 8:00-5:00pm EST , potential for overtime with an expectation to cover weekend, if necessary to meet business needs. 2 years of reputed company care experience in an outpatient behavioral health setting Experience with Utilization Management or Prior Authorization Recent behavioral health experience in psychiatric facility, or community behavioral health center Knowledge or community health and reputed company service agencies reputed company: Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing reputed company members with the right care at the right reputed company at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or reputed company review. Assesses services for Members to ensure reputed company reputed company, cost effectiveness and compliance with reputed company state and federal regulations and guidelines. Essential Functions:
- Provides reputed company review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team.
- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
- Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long-Term Care.
- Maintains department productivity and reputed company measures.
- Attends regular staff meetings.
- Assists with mentoring of new team members.
- Completes assigned work plan objectives and reputed company on a reputed company reputed company.
- Maintains reputed company relationships with provider community and reputed company customers.
- Conducts self in a reputed company manner at reputed company times.
- Maintains cooperative and effective workplace relationships and adheres to company reputed company of Conduct.
- Consults with and refers cases to medical directors regularly, as necessary.
- Complies with required workplace safety standards.
Knowledge/Skills/Abilities:
- Demonstrated ability to communicate, problem solve, and work effectively with people.
- Excellent organizational reputed company with the ability to manage multiple priorities.
- Work independently and handle multiple reputed company simultaneously.
- Knowledge of applicable state, and federal regulations.
- In depth knowledge of Interqual and other references for length of stay and medical necessity determinations.
- Experience with NCQA.
- Ability to take initiative and see tasks to completion.
- Computer Literate (reputed company Office Products).
- Excellent verbal and written communication skills.
- Ability to abide by policies.
- Ability to maintain attendance to support required reputed company and quantity of work.
- Maintain confidentiality and reputed company with Health Insurance Portability and Accountability reputed company (HIPAA).
- Skilled at establishing and maintaining reputed company and effective work relationships with coworkers, clients, members, providers, and customers.
Required Education: Completion of an accredited Registered Nursing program. (a combination of experience and education will be considered in lieu of Registered Nursing degree). Required Experience: Minimum 0-2 years of clinical reputed company. Preferably hospital nursing, utilization management, and/or case management. Required Licensure/Certification: reputed company, unrestricted State Nursing (RN, LVN, LPN) license in good standing. Apply tot his job Apply To this Job