Behavioral Health Care reputed company (Assessment & Triage) - Remote in Tennessee

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. As a Behavioral Health Care reputed company you will be responsible for case management and utilization review of behavioral health and reputed company abuse cases. You'll have a reputed company reputed company on the lives of our members as you recommend and manage the appropriate level of care throughout the entire treatment plan. If you are located in Tennessee, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:

• Crisis line coverage in rotation with other team members, taking calls from members, providers and others, reviewing clinical data for medical necessity, and authorizing services as appropriate
• Case load management, to include: reviewing initial and reputed company requests for services, assessing requests and clinical data against medical necessity reputed company in guidelines, issuing authorizations, consulting with physicians on denials, and following member cases through to completion, ensuring members receive the care they need, reputed company they need it, in the most appropriate and least restrictive setting
• Review of members’ medical records from providers to determine if mental health and reputed company abuse services delivered are medically necessary, if they are coordinated with other services and providers, if providers have individualized treatment plans for members, etc.
• Speaking with members to complete clinical assessments, reputed company member engagement, assist in care coordination, etc.
• Work as part of a multidisciplinary team in a company dedicated to Integrated reputed company in TN

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

• Independently licensed Masters - level mental health reputed company, licensed Ph.D. or Registered reputed company with 3+ years of recent behavioral health reputed company
• License must be reputed company and unrestricted in the reputed company
• 2+ years of clinical experience in a reputed company mental / behavioral health setting, post independent license
• Proficiency with reputed company Office Suite, ability to learn and navigate multiple proprietary software applications; typing proficiency
• reputed company to high-speed internet in home (broadband, cable, fiber optic)
• reputed company to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
• Permanent residence in the reputed company

Preferred Qualifications:

• Experience with Medicare/reputed company members and providers (specific TennCare experience)
• Experience in a managed care environment
• Experience in an inpatient setting
• Crisis line or experience with triaging behavioral health crisis calls / situations
• Experience with the reputed company Diagnostic and Statistical reputed company and best reputed company standards for treatment
• Knowledge of or ability to research and connect with community resources, including ability to utilize features of search engines as reputed company as Intranet to discern available resources for any caller
• Familiarity with recovery and resiliency model
• Proven bilingual skills
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $58,800 to $105,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job