Remote Behavioral Health Utilization Lead

Banner Health; Arizona; Remote; USD 39,000 - 65,000; Full time

Job summary

Banner Health in remote Arizona is seeking a Behavioral Health Utilization Care Manager to review prior authorization requests for outpatient behavioral health and ensure medical necessity. You will collaborate with providers and interdisciplinary teams, support timely care decisions, and participate in expanding prior authorization programs across inpatient, residential and outpatient settings.

The role requires an MSW or related field and state licensure (LCSW/LMSW/LPC/LAC), plus at least

Qualifications

• Master’s degree in social work, counseling or related field.
• Licensed in at least one of: LCSW, LMSW, LPC, LAC or Licensed Psychologist.
• Three years of clinical experience in counseling, care management or case management.
• Knowledge of care management, hospital and community resources.
• Strong critical thinking, problem-solving, communication and time management.

Responsibilities

• Manages individual members across the health care continuum to achieve optimal clinical, financial, operational, and satisfaction outcomes.
• Acts in a leadership function with process improvement activities for populations of patients.
• Evaluates medical necessity and appropriateness of care, optimizing patient outcomes.
• Establishes and promotes a collaborative relationship with physicians, payers, and health care team members.
• Leads development and management of interdisciplinary discharge plan and communicates it across the care continuum.
• Educates internal team on case management concepts and integrates them into daily practice.
• Operates within established procedures and consults supervisor on unusual situations.

Skills

Critical thinking

Problem solving

Communication skills

Time management

Independent and team work

Education

MSW or related field

State licensure (LCSW/LMSW/LPC/LAC/PhD)

Job description

Banner Health in remote Arizona is seeking a Behavioral Health Utilization Care Manager to review prior authorization requests for outpatient behavioral health and ensure medical necessity. You will collaborate with providers and interdisciplinary teams, support timely care decisions, and participate in expanding prior authorization programs across inpatient, residential and outpatient settings.

The role requires an MSW or related field and state licensure (LCSW/LMSW/LPC/LAC), plus at least