Behavioral Health Care Management Coordinator

IntePros; Philadelphia (Philadelphia County); Remote; USD 65,000 - 85,000; Full time

Job summary

A leading company is seeking a Behavioral Health Care Management Coordinator to evaluate treatment needs and ensure compliance with clinical guidelines. This remote position requires licensure and offers the chance to make a meaningful impact in behavioral healthcare. Join a collaborative team focused on professional growth and support for members navigating the healthcare system.

Benefits

Professional growth opportunities

Collaborative team culture

Meaningful work

Qualifications

• Minimum of 3 years of clinical behavioral health experience.
• Experience in behavioral health utilization management preferred.

Responsibilities

• Review clinical documentation to assess medical necessity.
• Independently authorize care based on clinical criteria.
• Communicate with providers to clarify treatment plans.

Skills

Clinical Assessment

Critical Thinking

Communication

Organizational Skills

Time Management

Education

Bachelor of Science in Nursing

Tools

Microsoft Office

Job description

Job Title: Behavioral Health Care Management Coordinator

Location: Remote – Must reside in the tri-state area (PA, NJ, DE)

Job Type: Full-Time

Licensure Required: RN (PA), LSW, LCSW, LPC, or LMFT

Position Summary

We are seeking a dedicated Behavioral Health Care Management Coordinator to join our team. This licensed professional will play a critical role in evaluating behavioral health treatment needs and ensuring that services provided to our members are medically necessary and in line with established clinical guidelines.

You will be responsible for conducting thorough reviews of medical and treatment records, applying medical necessity criteria (such as InterQual and ASAM), and making independent authorization decisions. While you have the authority to approve services, cases that don’t meet the criteria will be escalated to a Medical Director for further review.

This is a remote position, but candidates must live in Pennsylvania, New Jersey, or Delaware.

Key Responsibilities

• Review clinical documentation to assess medical necessity for behavioral health services using InterQual, ASAM, and medical policies.
• Independently authorize care based on clinical criteria; refer non-approvable cases to a Medical Director.
• Communicate with providers to clarify treatment plans and obtain additional information as needed.
• Identify opportunities for early intervention and coordinate with case management to facilitate timely discharges.
• Ensure all care determinations are in compliance with state, federal, and accreditation requirements.
• Maintain accurate and timely documentation in all systems according to policy.
• Collaborate with internal departments and external providers to advocate for the member and support access to appropriate care.
• Refer cases to Quality Management, Case Management, or Disease Management teams as needed.
• Meet or exceed productivity and regulatory turnaround time benchmarks.
  
  

Qualifications

Licensure (Required)

• Active PA RN License, or
• LSW, LCSW, LPC, or LMFT
  
  

Education

• Bachelor of Science in Nursing (BSN) preferred
  
  

Experience

• Minimum of 3 years of clinical behavioral health experience in a hospital or healthcare setting
• Experience in behavioral health utilization management or medical precertification preferred
  
  

Skills & Competencies

• Strong clinical assessment and critical thinking skills
• Excellent verbal and written communication skills
• Proficiency with Microsoft Office (Word, Outlook, Excel, SharePoint, Adobe)
• Strong organizational and time management skills
• Ability to adapt to change and thrive in a fast-paced environment
• Team-oriented and collaborative, with a commitment to diversity and inclusion
  
  

Why Join Us?

• Meaningful work supporting individuals navigating the behavioral healthcare system
• Opportunity to work remotely while making a measurable impact
• Collaborative and mission-driven team culture
• Professional growth and training opportunities
  
  

Apply today to become part of a team that is committed to making a difference in the lives of our members.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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