BH Utilization Manager

Academy of Managed Care Pharmacy; Houston (TX); Remote; USD 60,000 - 90,000; Full time

Job summary

An innovative organization is seeking a Behavioral Health Utilization Manager to enhance their Behavioral Health Program. This role involves reviewing clinical information to authorize necessary care, utilizing evidence-based criteria. The ideal candidate will have a Master's Degree in Social Work or a related field, alongside clinical experience in mental health settings. Strong communication and analytical skills are essential for success in this position. Join a dedicated team and contribute to improving community health outcomes while working flexibly and independently.

Qualifications

• Master's Degree required with an unrestricted Texas License.
• Two years of clinical practice in relevant settings.

Responsibilities

• Assist in the Behavioral Health Program reviewing clinical information.
• Authorize medically necessary inpatient and outpatient care.

Skills

Verbal Communication

Writing Skills

Analytical Skills

Medical Terminology

Research Skills

Education

Masters Degree in Social Work or related field

Tools

MS Word

MS Excel

Outlook

Job description

JOB SUMMARY:

Behavioral Health Utilization Manager will assist the overall Behavioral Health Program for Community Health Choice in the review of telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines

MINIMUM QUALIFICATIONS:

Education/Specialized Training/Licensure: Masters Degree
Unrestricted Texas License including: LCSW, LMFT, LPC, or RN

Work Experience (Years and Area):
Two (2) years Clinical practice at an Acute Psychiatric Hospital, Mental Health Agency, or Utilization Management Program.
Two (2) years Managed Care Experience Preferred.

Equipment Operated: Computer literate with knowledge of MS Word, MS Excel, Outlook, and telephone systems. Also able to navigate clinical platforms

SPECIAL REQUIREMENTS:

Communication Skills:
Above Average Verbal (Heavy Public Contact)
Writing /Composing (Correspondence / Reports)

Other Skills:
Analytical
Dictation/Transcription
Medical Terminology
Research
PC
MS Word
MS Excel

Advanced Education: Master's Degree Major: Social Work or related field

Work Schedule: Flexible

Other Requirements: Able to work independently under general instructions and working within a team environment. Ability to self manage while working remotely

RESPONSIBLE TO: Supervisor/Manager

EMPLOYEE SUPERVISED: None