Behavioral Health Care Coordinator - Part-Time, Exempt Position (Req# R0010200)

Health Care Service Corporation; Albuquerque (NM); Remote; USD 50,000 - 80,000; Part time

Job summary

An established industry player is seeking a dedicated Telecommuter Behavioral Health Review Specialist to join their team. This part-time role offers a unique opportunity to apply your clinical expertise in a flexible telecommuting environment. You will be responsible for conducting thorough clinical reviews of behavioral health cases, ensuring compliance with medical necessity criteria. Ideal candidates will possess strong analytical and communication skills, along with a solid background in psychiatric care. This position allows you to make a meaningful impact in the lives of members while enjoying the flexibility of a telecommuting schedule.

Qualifications

• At least 3 years of clinical experience in a psychiatric setting or own behavioral health practice.
• Current clinical license in good standing.

Responsibilities

• Ensure accurate and timely clinical review of behavioral health cases for medical necessity.
• Assist members via telephone and review medical records.

Skills

Verbal Communication

Written Communication

Analytical Skills

Decision-Making Skills

Database Management

Education

Registered Nurse (RN)

Masters-level Behavioral Health Professional

Tools

PC

Database Management Software

Job description

Job Title: Telecommuter Behavioral Health Review Specialist

This is a telecommuter role based in Albuquerque, Chicago, Richardson, and Tulsa headquarters.

Position Details:

• Part-Time, Exempt status - 32 hours/week
• Evenings and weekends schedule

Work Schedule:

1. One 8-hour shift on Friday nights from 12:30 am to 8:30 am (Saturday morning)
2. Two 12-hour shifts on Saturday and Sunday nights from 8:30 pm to 8:30 am

Must Have: At least 3 years of clinical experience post-licensure at the independent practice level in a psychiatric setting/outpatient facility, or own behavioral health practice.

Job Summary

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. Responsibilities include assisting members via telephone, reviewing medical records, interpreting behavioral health diagnoses, and applying knowledge of medical necessity criteria across all levels of behavioral health care, from outpatient visits to inpatient care.

Job Requirements

• Registered Nurse (RN) with current license or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, RPsy) with a current license to practice independently.
• Current clinical license in the state of operation, in good standing.
• At least 3 years of clinical experience in a psychiatric setting or own behavioral health practice.
• Strong verbal and written communication skills.
• Analytical and decision-making skills.
• Experience with PC and database management.

Preferred Job Requirements

• Utilization review experience.

Additional Notes:

• Relocation assistance will not be provided for this position.
• Sponsorship will not be provided for this position.