Behavioral Health Utilization & Care Coordinator

Cbhphilly; Philadelphia, Northern (Philadelphia County, KY); Hybrid; USD 66.000 - 67.000; Vollzeit

Zusammenfassung

CBH is seeking a Clinical Care Manager PES in Philadelphia, PA. The role focuses on utilization management, population management, cross-system consultation, and ensuring access to medically necessary behavioral health services.

The position requires a Master’s degree in Social Work or related field, licensure within 18 months, and strong coordination with medical leadership to optimize care for CBH members.

Qualifikationen

• Master’s degree in Social Work or related field required.
• License within 18 months of employment; PA Child Abuse Clearance required.
• Licenses: LSW, LPC, LMFT, or LCSW required.

Aufgaben

• Perform utilization management activities including reviews, care coordination, and provider meetings.
• Ensure medical necessity criteria are applied and treatment is appropriately authorized.
• Collaborate with physicians, psychologists, and clinical leadership for optimal treatment plans.
• Maintain accurate documentation in CBH’s electronic system and participate in supervision.
• Engage with members and providers to address social determinants and barriers to wellness.

Kenntnisse

Clinical care management

Utilization management

Interdisciplinary collaboration

Communication skills

MS Office

HIPAA compliance

Ausbildung

Master’s degree in Social Work or related field

Tools

MS Office (Excel)

Jobbeschreibung

CBH is seeking a Clinical Care Manager PES in Philadelphia, PA. The role focuses on utilization management, population management, cross-system consultation, and ensuring access to medically necessary behavioral health services.

The position requires a Master’s degree in Social Work or related field, licensure within 18 months, and strong coordination with medical leadership to optimize care for CBH members.