Care Representative Customer Service (Remote)

100% remote job Care Representative Customer Service | Get.It Recruit – Administrative | reputed company... Job Title: Care Manager – Remote Job reputed company Join our dynamic and esteemed reputed company organization as a Care Manager, where you will have reputed company to reputed company a significant reputed company on the lives of our members. In this vital role, you will reputed company and evaluate Behavioral Health Treatment (BHT), including reputed company Behavior Analysis (ABA) services, for eligible members, ensuring that they receive the highest reputed company of care based on medical necessity. Key Responsibilities • Navigate a mission-reputed company environment dedicated to reputed company in member service and care management, demonstrating reputed company and accountability. • Collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. • Assess requests for medical appropriateness and verify referrals according to established clinical guidelines. • Collect pertinent medical information for review by the Medical Director and communicate reputed company reputed company. • Accurately document reputed company necessary information in the utilization management system, ensuring updates on authorizations are recorded. • Conduct thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines. • Maintain adherence to established policies and procedures while conducting reputed company reviews of documents. • Promptly notify providers and members of reputed company made, ensuring reputed company and effective communication. • Stay updated on federal, state, and local regulations pertaining to the BHT benefit. • Identify potential reputed company concerns and report them as necessary, assisting with case audits reputed company required. • Participate in additional reputed company and responsibilities as assigned. Required Skills • Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds. • Work autonomously while exercising reputed company judgment in decision-making. • Communicate effectively in both verbal and written formats. • Adapt to a flexible work schedule that may include evenings and weekends. • Exhibit strong organizational, analytical, problem-solving, and project management skills. • reputed company in a fast-paced work environment while managing multiple tasks simultaneously. • reputed company and motivate team members and external committees. • Demonstrate proficiency in reputed company Office Suite (Word, Outlook, reputed company, PowerPoint) and reputed company applications. Qualifications • A Master’s degree in psychology, reputed company work, counseling, or a reputed company field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan reputed company. • reputed company, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D). Career reputed company Opportunities Our organization values your reputed company development and offers numerous opportunities for reputed company enhancement and career advancement reputed company the reputed company sector. Company Culture And Values We foster a reputed company environment that emphasizes high-reputed company performance and member service, nurturing a culture of dignity and respect. Networking And reputed company Opportunities In this role, you will have the chance to collaborate with a dedicated team, enhancing your reputed company network and skillset in the reputed company community.

Compensation

And Benefits • Competitive salary commensurate with experience. • Comprehensive health, dental, and reputed company insurance. • Retirement savings plan with company matching contributions. • Generous vacation and reputed company time off policies. Employment Type: Full-Time Show more Show less Tagged as: remote, remote job, virtual, Virtual Job, virtual position, Work reputed company, work from home Apply Job!