Reference #: 897904
Behavioral Health Care Management Coordinator-RemoteCategory:
HealthcareEmployment Type:
ContractReference:
BH-372762Behavioral Health Care Management Coordinator-remote
needed for a contract
opportunity with Yoh's client located in Philadelphia, PATop Skills You Should Possess:LCSW or LMFT or LPC or Active PA Licensed RN, BSN Preferred
Position will be remote but will need to reside in tri-state area (PA, NJ, DE).
Will need your own computer
What You'll Be Doing:The Behavioral Health (BH) Care Management Coordinator primary responsibility is to evaluate a member's BH condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient's services
Reviews treatment plans/plan of care with provider for requested services/procedures, inpatient admissions or continued stay, clarifying behavioral health information with provider if needed.
Identifies and refers cases in which the plan of care/services are not meeting established criteria to the Medical Director for further evaluation determination.
Performs early identification of members to evaluate discharge planning needs.
Collaborates with case management staff or physician to determine alternative setting at times and provide support to facilitate discharge to the most appropriate setting.
Reports potential utilization issues or trends to designated manager and recommendations for improvement.
Appropriately refers cases to the Quality Management Department and/or Care Management and Coordination Manager when indicated to include delays in care.
Appropriately refers cases to Case and Disease Management.
Ensures request is covered within the member's benefit plan.
Ensures utilization decisions are compliant with state, federal and accreditation regulations.
Meets or exceeds regulatory turnaround time and departmental productivity goals when processing referral/authorization requests.
Ensures that all key functions are documented in accordance with Care Management Coordination Policy.
Maintains the integrity of the system information by timely, accurate data entry.
Performs additional duties assigned.
What You Need to Bring to the Table:(3) years of Behavioral Health clinical experience in a hospital or other health care setting.
Prior Behavioral Health utilization management experience is desirable
LCSW or LMFT or LPC or Active PA Licensed RN, BSN Preferred
What's In It for You?Join Yoh's extensive talent community that will provide you with access to Yoh's vast network of opportunities.
Weekends and holidays off
Direct deposit & weekly epayroll
What are you waiting for? APPLY NOW!Note: Any pay ranges displayed are estimations. Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description. All qualified applicants are welcome to apply.Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.Visit
to contact us if you are an individual with a disability and require accommodation in the application process.Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V.