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A healthcare organization is seeking a remote clinical professional responsible for reviewing behavioral health cases for medical necessity. The ideal candidate will be a Registered Nurse or licensed Behavioral Health Professional with significant experience in psychiatric settings. Responsibilities include assisting members over the phone and reviewing clinical cases. Competitive compensation ranges from $60,300.00 to $133,400.00, based on skills and location.
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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 involves 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 in-patient to out-patient office visits.
JOB REQUIREMENTS:
PREFERRED JOB REQUIREMENTS:
This is a Telecommute (Remote) role for TX, OK, NM, MT and IL.
Sponsorship is not available
Compensation: $60,300.00 - $133,400.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please visit our website.