Remote Utilization Coordinator - Behavioral Health

Greater-Oregon-Behavioral-Healt; Bend (OR); Remote; USD 85,000 - 105,000; Full time

Benefits offered by this job

Competitive salary

Bilingual skills bonus (Spanish)

Medical, dental and vision insurance

Paid time off

Flexible working schedule

Retirement plan (401k)

Mileage reimbursement

Cell phone and internet reimbursements

Job summary

Greater Oregon Behavioral Health, Inc. (GOBHI) is seeking an Utilization Management Coordinator for a remote Oregon position.

The role delivers clinical review of mental health and substance use treatment requests to ensure medically necessary services and better health outcomes. Responsibilities include reviewing authorizations, communicating results to providers, and collaborating with multidisciplinary teams.

Qualifications

• Five years’ experience working with individuals with a severe and persistent mental illness.
• Ability to communicate effectively at multiple levels.
• Strong attention to detail, planning, and organizational skills.
• Resourceful, able to network and connect people to appropriate resources.
• Technology savvy – proficient using MS software or Google Suites.
• Maintains good driving record and required vehicle insurance.
• Master’s degree in behavioral health required.
• Licensed clinical social worker or licensed professional counselor.
• Must be able to work occasional rotating on call hours.

Responsibilities

• Review authorization requests to determine needed information and request additions.
• Review medical, mental health and substance use information and make authorization decisions.
• Issue decision notices based on unit protocols.
• Participate in reviews for clinical quality and program structure.
• Gather and assemble documents for appeal and second reviews.
• Collaborate with community providers, state/county workers, vendors and teams.
• Provide direction to non-clinical Care Coordination staff.
• Provide technical assistance to providers in person or over video.
• Review contract expectations for authorizations.
• Drives to GOBHI locations as needed.
• Performs other related duties as assigned.

Skills

Communication

Attention to detail

Networking

Technology proficiency

Education

Master’s degree in behavioral health

Tools

MS Office

Google Suite

Job description

Greater Oregon Behavioral Health, Inc. (GOBHI) is seeking an Utilization Management Coordinator for a remote Oregon position.

The role delivers clinical review of mental health and substance use treatment requests to ensure medically necessary services and better health outcomes. Responsibilities include reviewing authorizations, communicating results to providers, and collaborating with multidisciplinary teams.