Behavioral Health Case Manager - Remote

MassGenics, Inc.; Philadelphia (Philadelphia County); Hybrid; USD 55,000 - 62,000; Full time

Benefits offered by this job

Referral bonus program

Benefits package

Job summary

Innova Solutions is hiring a Behavioral Health Clinician for a full-time contract in Philadelphia, PA with remote options. You will apply clinical judgment using InterQual and Medical Policy to determine medical necessity for inpatient and discharge planning, review plans with providers, and ensure adherence to regulatory requirements.

The ideal candidate has at least three years of Behavioral Health experience and holds an active PA license (LCSW/LMFT/LPC or RN).

Qualifications

• Minimum of three (3) years of Behavioral Health clinical experience in a hospital or other health care setting.
• LCSW or LMFT or LPC or Active PA Licensed RN

Responsibilities

• Apply clinical judgment using InterQual and Medical Policy to determine medical appropriateness of proposed plans.
• Determine needs for inpatient, continued stay, and length of stay and related services.
• Review treatment plans with providers and clarify medical information when needed.
• Refer cases to Medical Director when plans do not meet criteria and support discharge planning.
• Collaborate with case management staff and physicians to identify alternate settings to facilitate discharge.
• Report utilization issues and trends to managers with recommendations for improvement.
• Ensure regulatory compliance and timely documentation of all actions in the care management system.

Skills

Behavioral Health clinical experience

Licensed clinician credentials

Job description

Innova Solutions is hiring a Behavioral Health Clinician for a full-time contract in Philadelphia, PA with remote options. You will apply clinical judgment using InterQual and Medical Policy to determine medical necessity for inpatient and discharge planning, review plans with providers, and ensure adherence to regulatory requirements.

The ideal candidate has at least three years of Behavioral Health experience and holds an active PA license (LCSW/LMFT/LPC or RN).