Behavioral Health Care Coordinator

VIVA USA Inc; Chicago (IL); On-site; USD 70,000 - 100,000; Full time

Job summary

VIVA USA Inc. is seeking a clinician to perform timely and accurate clinical reviews of behavioral health cases for medical necessity, from outpatient visits to acute inpatient care. You will assist members by phone, review records, and interpret contracts while applying medical necessity criteria.

The role requires an active clinical license (RN or Masters-level BH professional) and at least 3 years of psychiatric care experience. Strong communication and analytical skills are essential.

Qualifications

• Must hold an active clinical license in the state of operation or an equivalent independent practice license.
• Minimum 3 years of clinical experience in a psychiatric setting or behavioral health practice.
• Strong verbal and written communication skills and analytical decision-making abilities.

Responsibilities

• Conduct timely and accurate clinical reviews of behavioral health cases for medical necessity across levels of care.
• Assist members by phone and review medical records and contract interpretations.
• Apply knowledge of medical necessity criteria for outpatient to inpatient behavioral health care.

Skills

Verbal and written communication

Analytical decision making

PC and database experience

Education

Registered Nurse license (RN)

Masters-level Behavioral Health Professional license

Job description

This position is responsible for 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, and 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.

PREFERRED JOB REQUIREMENTS

• Utilization review experience.
• Required Qualification(s)
• BH experience, managed care preferred

Notes

Contract to Hire

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status