Virginia Licensed Behavioral Health Coordinator

Konsus, Inc. (Superside); United States; Remote; USD 55,000 - 75,000; Full time

Job summary

A leading healthcare company is seeking a Behavioral Health Utilization Management Care Coordinator to work remotely in Virginia and North Carolina. This role involves reviewing clinical information, ensuring compliance with medical necessity criteria, and effectively coordinating care within the behavioral health framework. Candidates should hold a Master's or Bachelor's degree in relevant fields, along with the required licensure to practice in Virginia. This position offers a chance to contribute to health management while working from home.

Qualifications

• Master's or Bachelor's degree in relevant fields is required.
• License in Virginia as LCSW, LPC, LMFT, or RN is required.
• Two years of clinical and behavioral health experience required.

Responsibilities

• Review clinical information to ensure it meets Medical Necessity Criteria.
• Maintain knowledge of medical necessity criteria and compliance requirements.
• Enter accurate information into the claims system.

Skills

Clinical experience

Behavioral health knowledge

Case management

Education

Master's Degree in Social Work or Counseling

Bachelor's Degree in Nursing

Licensed LCSW, LPC, LMFT, or RN in Virginia

Job description

A company is looking for a Behavioral Health Utilization Management Care Coordinator (LCSW/LPC/LMFT/RN) to work remotely in Virginia and North Carolina.

Key Responsibilities

• Review clinical information to ensure it meets Medical Necessity Criteria for service authorization
• Maintain knowledge of medical necessity criteria, DMAS protocols, and compliance requirements
• Enter accurate information into the claims system for payment processing

Required Qualifications, Training, and Education

• Master's Degree in Social Work or Counseling or Bachelor's Degree in Nursing is required
• Current license as LCSW, LPC, LMFT, or RN in Virginia is required
• Two years of clinical experience is required
• Two years of experience in behavioral health and one year in care coordination is required
• One year of case management experience is preferred