Behavioral Health Utilization Management Specialist

Ampcus Inc; Columbia (MD); Presencial; USD 90.000 - 120.000; Tempo integral

Benefícios oferecidos por esta vaga

Health & Wellness insurance

Life Insurance

Retirement Savings: 401(k)

Resumo da vaga

Ampcus Inc. is seeking a Behavioral Health Utilization Management Specialist to perform prospective, concurrent and retrospective reviews for authorization and appropriateness of care in medical and behavioral health services.

The position requires a Master’s in Psychology or Social Work, MD/DC/VA LCPC or LCSW-C licensure, 5 years of clinical experience, and strong written/interpersonal communication skills. Proficiency in MS Office is expected.

Qualificações

• Master’s degree in Psychology or Social Work is required.
• Minimum 5 years of clinical experience; 2 years in care management preferred.
• MD/DC/VA licensure as LCPC or LCSW-C required.
• Strong written and interpersonal communication skills.
• Proficient with Microsoft Office (Word, Excel, PowerPoint).

Responsabilidades

• Determine medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, and accepted medical references.
• Conduct research and analysis of pertinent diseases, treatments and emerging technologies to support decisions and recommendations to medical directors.
• Make appropriate referrals and contacts as appropriate; offer assistance to members and providers for alternative care settings.

Conhecimentos

Written communication

Interpersonal communication

Regulatory knowledge

Clinical utilization management

Formação

Master’s Degree in Psychology or Social Work

Ferramentas

Microsoft Office

Descrição da vaga

Ampcus Inc. is seeking a Behavioral Health Utilization Management Specialist to perform prospective, concurrent and retrospective reviews for authorization and appropriateness of care in medical and behavioral health services.

The position requires a Master’s in Psychology or Social Work, MD/DC/VA LCPC or LCSW-C licensure, 5 years of clinical experience, and strong written/interpersonal communication skills. Proficiency in MS Office is expected.