BH Utilization Manager

Case Management Society of America (CMSA) ®; Houston (TX); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Behavioral Health Utilization Manager to enhance their Behavioral Health Program. This pivotal role involves reviewing clinical information to ensure the authorization of necessary care, utilizing evidence-based criteria. Candidates should possess a Master's Degree in Social Work or a related field, along with an unrestricted Texas license. The ideal applicant will have strong analytical and communication skills, as well as experience in clinical practice and managed care. Join a dynamic team that values flexibility and independent work, contributing to a vital health initiative.

Qualifications

• Masters Degree in Social Work or related field required.
• Two years clinical practice in mental health or utilization management.

Responsibilities

• Review clinical information to authorize inpatient and outpatient care.
• Assist in the overall Behavioral Health Program.

Skills

Verbal Communication

Writing Skills

Analytical Skills

Medical Terminology

Research Skills

Education

Masters Degree in Social Work

Unrestricted Texas License (LCSW, LMFT, LPC, RN)

Tools

MS Word

MS Excel

Outlook

Clinical Platforms

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