Care Coordinator

Work Place Options; Birmingham (AL); On-site; USD 55,000 - 75,000; Full time

Job summary

Workplace Options in Birmingham, Alabama, seeks a Care Coordinator to oversee patient care activities within the Clinical Services Division. The role includes referrals, case management, benefits administration, and participation in utilization review.

The ideal candidate holds a Masters in Psychology or a related field, with licensed credentials in the behavioral health field and at least five years in mental health.

Qualifications

• Masters degree in Psychology or related field is required.
• Active, professional licensure or certification to practice in the behavioral health field in the US is required.
• QA/UR experience in psychiatric settings is preferred.
• Minimum five years of experience in mental health is expected.
• Experience with services to business/industry is a plus.
• Exposure to computerized applications is expected.
• Strong organizational and communication skills are essential.

Responsibilities

• Oversee and coordinate all patient care activities within the Clinical Services Division.
• Perform referral and case management across all client locations and ensure benefits administration.
• Participate in utilization review and quality assurance activities as directed.
• Coordinate intake, scheduling, and coverage for the Clinical Services Division.
• Maintain patient and departmental files, budgets, and policy adherence.

Skills

Strong organizational skills

Excellent communication skills

QA/UR experience

Education

Masters degree in Psychology or related field

Job description

We know that finding a meaningful and rewarding job can be a long journey.

Our goal is to make that process as easy as possible for you. Start your journey with us by browsing available jobs.

At Workplace Options, we are committed to and are accountable for building a workplace where individuals feel empowered to bring their whole selves to work, free from judgment or fear of discrimination. We understand that having a diverse organization is only the beginning and it will require nurturing and care to thrive. We will continue to take action to ensure we achieve equitable and measurable outcomes.

We strive to cultivate a space where diverse voices are not only heard but actively sought out and valued for the unique insights they bring. By embracing and promoting authenticity, we aim to build a vibrant and inclusive community that fosters collaboration, innovation, belonging and personal growth.

We know that searching for a meaningful and rewarding job can be a long journey. Notre objectif est de rendre ce processus aussi facile que possible pour vous. Commencez votre parcours avec nous en consultant les offres d'emploi disponibles. Chez Workplace Options, nous nous engageons à construire un lieu de travail où les individus se sentent habilités à apporter leur entièreté au travail, sans jugement ni crainte de discrimination, et nous en sommes responsables. Nous comprenons qu'une organisation diversifiée n'est qu'un début et qu'elle aura besoin de soins et d'attention pour s'épanouir. Nous continuerons à prendre des mesures pour obtenir des résultats équitables et mesurables.

Nous nous efforçons de cultiver un espace où les différentes voix sont non seulement entendues, mais aussi activement recherchées et appréciées pour les perspectives uniques qu'elles apportent. En embrassant et en promouvant l'authenticité, nous visons à construire une communauté dynamique et inclusive qui favorise la collaboration, l'innovation, l'appartenance et l'épanouissement personnel.

Care Coordinator

Location: Birmingham, AL

Full Time / Part Time: This is a full-time (40 hours per week) position.

Healthcare

Mid Level

About This Opportunity

Workplace Options is proud to support our sister organization, Behavioral Health Systems (BHS), in recruiting a Care Coordinator.

BHS operates one of the nation’s largest specialty preferred provider organizations (PPO), which is comprised of psychiatrists, psychologists, social workers, EAP providers as well as facility networks including hospitals, rehab/residential treatment centers, partial hospitalization programs and intensive outpatient programs. BHS fully credentials and panels their own network of providers.

Current Opportunity: Care Coordinator

Location: Alabama (Birmingham)

Full-time/Part-time: This is a full-time (40 hours per week) position.

What You Will Do

Reporting to the Vice President, Clinical Services, this position is responsible for overseeing and coordinating all patient care activities within the Clinical Services Division. Specific responsibilities include referral and case management activities across all client locations, clinical administration of client benefits and participation in utilization review and quality assurance activities.

• Perform care management coordination activities for managed care, employee assistance, and workers’ compensation beneficiaries system-wide to include: scheduling and direct case management reviews, communication with hospitals, attending physicians, outpatient providers, etc., effectiveness review and monitoring functions, quality assurance.
• Receive calls from patients, providers, and facilities; arrange for appropriate intake assessments; schedule and refer to appropriate case manager in local area. Perform appropriate monitoring activities on a regular basis. Provide coverage to the Clinical Services Division as deemed necessary.
• Explain benefits to employees, patients and treatment providers. Verify benefit eligibility and maintain appropriate communication with Client company contacts. Maintain positive interactions with patients, providers and Clients.
• Participate in utilization review and quality assurance activities, as directed. Coordinate U.R. activities with the BHS physician review panel as appropriate, to include ensuring on-going and timely peer/clinical review of active inpatient and outpatient cases.
• Adhere to established BHS clinical policies, procedures and utilization review guidelines, HIPAA standards, ERISA regulations, URAC standards.
• Review incoming claims for completeness of data and appropriate approval, in cooperation with data processing and the Accounting Division. Cooperate in data analysis process by other divisions.
• Serve as clinical liaison for EAP accounts to include communication with clients, assisting Vice President, EAP with quarterly and annual reports.
• Provide after hours coverage for emergencies on a shared basis, collecting data based on structured intake questionnaire and arranging for peer review.
• Assist in the clinical coordination of patient activities and cases as requested.
• In cooperation with the Provider Relations Division facilitate emergency case-specific facility hook-ups or transfers as deemed appropriate. Maintain contact with members as needed regarding the status of provider requests.
• Interact with the BHS physician review panel and coordinate case reviews for medical necessity purposes. Maintain strong liaison with physician reviewers and the BHS Medical Director.
• Maintain patient and departmental files, policies, procedures, budgets. Assist in achievement of annual goals, objectives and divisional action plans.
• Perform other related duties as directed or deemed appropriate. Attend meetings as directed. Maintain professional competency through continuing education, conferences, and internal training.

Qualifications

• Masters degree in Psychology or related field required
• Active, professional licensure or certification to practice in the behavioral health field in a state or territory of the United States required
• QA/UR experience in psychiatric setting
• Minimum five years experience in mental health field
• Prefer experience in services to business and industry
• Exposure to computerized applications
• Strong organizational and communication skills

For further information about BHS please see https://behavioralhealthsystems.com/providers/

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