Episodic Care Manager – Behavioral Health, Autism Services
E-Verify Program
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Salary
💰 $73,698 - $117,917 per year
About the role
- Perform clinical reviews to assess, facilitate, and coordinate the delivery of health care services
- Effectively coordinate with providers, members, and internal staff
- Review and evaluate cases for medical necessity against medical policy, benefits and/or care guidelines and regulations
- Provide notifications to member and/or provider, according to regulatory requirements
- Assess appropriateness for secondary case review by the Medical Director (MD) for denials
Requirements
- BCBA licensure with a minimum of 3 years of clinical experience
- Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties
- Previous experience with utilization management in Behavioral Health strongly preferred
Benefits
- Medical, dental, and vision coverage along with numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs and tuition reimbursement for continued education
- 401k match including an annual company contribution
- Work-life balance, flexibility, and the autonomy to do great work
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical reviewsmedical necessity evaluationcase coordinationutilization management
Soft Skills
effective communicationinterpersonal skillsorganizational skills
Certifications
BCBA licensurevalid clinical licenseNC licensurecompact multi-state licensure