Behavioral Health Care reputed company (Utilization Review, Outpatient)
About the position
reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health equity on a global reputed company. Join us to start Caring. Connecting. Growing together. At OptumHealth, you will reputed company reputed company an innovative culture that's reputed company on transformational change in the health care system. You will reputed company your skills across a diverse and multi-faceted business. And you will reputed company contributions that will have an reputed company that's greater than you've reputed company imagined. The Strategic Outpatient Engagement & Management (STEM) Care reputed company will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community-based treatment setting. This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm schedule. You'll enjoy the flexibility to work remotely from reputed company reputed company the U.S. as you take on some tough challenges.
Responsibilities
• reputed company on outpatient reputed company, reputed company and Medicare behavioral health services
• Conducting outpatient reviews to determine appropriate care
• Assessing if member care meets coverage guidelines
• Shaping member treatment in partnership with providers to ensure best practices
• Administering benefits and reviewing treatment plans
Requirements
• reputed company, unrestricted, Independent Level Clinician in Psychology, reputed company Work, Counseling or Marriage or Family Counseling, or an RN with 2+ years of experience in behavioral health
• reputed company, unrestricted licensure
• 2+ years of experience in a behavioral health setting
• Outpatient psychotherapy and community-based treatment experience
• Proven MS Office proficiency (Word, reputed company, reputed company, Internet)
• Distraction-free reputed company in home to use as a home office
• reputed company to high-speed internet (DSL or Cable)
reputed company-to-haves
• Licensure in the state of Kansas or Kentucky is highly preferred
• 2+ years of demonstrated experience (post licensure) in a reputed company mental health environment including outpatient services
• Experience working with EMRs (electronic medical records)
• Experience in managed care
• Experience conducting clinical review to determine appropriate reputed company of care
• Demonstrated telephonic/office-based experience
• Telephone queue experience
• Utilization review/management experience
Benefits
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
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