Job Summary

We are seeking a dedicated Behavioral Specialist to join our team.is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone.

Responsibilities:

· Ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone

· Reviewing medical records

· Reviewing cases which involve contract interpretation of behavioral health diagnoses.

· Utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute inpatient.

Job Requirements:



· Registered Nurse (RN) with active, current license or Masters-level Behavioral Health Professional with active, current license to practice at the independent practice level. Current clinical license to practice in state of operations and in good standings.

· 3 years clinical experience in psychiatric setting or own behavioral health practice.

· Verbal and written communication skills.

· Analytical and decision-making skills.

· PC and database experience.

· Preferably with Utilization review experience.

Job Types: Full-time, Contract

Pay: $35.00 - $40.00 per hour

Benefits:

• Health insurance

Schedule:

• Day shift

Application Question(s):

• What is your

License Number ?

Experience:

• Utilization management: 1 year (Required)

Work Location: Remote