Behavioral Health Utilization Management Clinician (LPC, LCSW, LMFT)Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix Apply
Standard business hours are required Monday-Friday.
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.
69424Fundamental Components: - Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate.
- Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
- Provides triage and crisis support.
- Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. determination/recommendation along the continuum of care facilitates including effective discharge planning.
- Coordinates with providers and other parties to facilitate optimal care/treatment.
- Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.
- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.
- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Background Experience: - Unencumbered Independent Behavioral Health clinical license for Arizona required (i.e. LPC, LCSW, LMFT)
- 3+ years of direct clinical practice experience required
- Crisis intervention skills preferred
- Managed care/utilization review experience preferred
- Minimum of a Master's degree in Behavioral/Mental health or Human Service/Health Services required
- Work requires sitting for extended periods, talking on the telephone and typing into the computer
- Sedentary work involving periods of sitting, talking, listening
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Additional Job Information:
|Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding|
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