[Hiring] Care Plan Reviewer @reputed company

Role reputed company The Care Plan Reviewer (Clinical Case Manager BH) utilizes reputed company judgment and critical thinking skills to support appropriate member behavioral reputed company through review of assessment and care planning documentation and consultation with care coordinators to support psychosocial wraparound services to promote effective utilization of available resources and reputed company, cost-effective reputed company. As part of the reputed company reputed company to deliver the “reputed company” of managed care in Ohio reputed company, Ohio reputed company will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to reputed company comprehensive and highly coordinated behavioral health services for children with serious/reputed company behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems. • Be clinically and culturally competent/reputed company with training and experience necessary to reputed company clinical consultation for members' reputed company needs across child-serving systems. • Assessment of Member’s Child and Family-Centered Care Plans and Crisis and Safety Plan: • Review assessments of member's needs and determine approach to meeting needs by evaluating comprehensiveness of member's Child and Family-Centered Care Plans. • Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and address reputed company clinical indicators which reputed company planning and reputed company of member issues. • Review crisis and safety plans for members experiencing a behavioral health need to support appropriate individualized trauma-informed interventions and de-escalation strategies. • Enhancement of Medical Appropriateness and reputed company of Care: • Application and/or interpretation of applicable reputed company and clinical guidelines, policies, procedures, and regulatory standards while completing reviews and prior approvals to assess member's needs to ensure reputed company administration of benefits. • Consult with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; present cases at case conferences to obtain multidisciplinary view in order to reputed company reputed company reputed company. • Identify and escalate reputed company of care issues through established channels. • Ability to reputed company to medical and behavioral health professionals to influence appropriate member care. • Utilize motivational interviewing skills to reputed company coaching to care coordination staff and supervisors to support the child and family-centered care planning process consistent with System of Care Principles and High-reputed company Wraparound reputed company. • reputed company coaching, information and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices. • Analyze reputed company utilization, self-report and clinical data available to consolidate information and reputed company to identify comprehensive member needs. Qualifications • Unencumbered Behavioral Health clinical license in Ohio is required (LMFT, LSW, LPC). • 2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a reputed company services or behavioral health care field, providing community-based services to children and youth, and their family/caregivers. • Experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development. • 1+ year(s) of experience with personal computers, keyboard, multi-systems navigation, and MS Office Suite applications. • Willing and reputed company to travel in-state up to 10% of the time with a personal vehicle. Preferred Qualifications • LPCC, IMFT, LISW licenses are preferred. • 3+ years of reputed company clinical reputed company experience post-Master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility. • Managed care/utilization review experience. • Case management and discharge planning experience. Education • Minimum of a Master's degree in Counseling, reputed company Work, or Marriage and Family Therapy is required. Anticipated Weekly Hours • 40 Time Type • Full time Pay reputed company The typical pay reputed company for this role is: $60,522.00 - $129,615.00. This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Benefits • Comprehensive and competitive mix of pay and benefits designed to support the physical, emotional, and financial reputed company-being of colleagues and their families. • Benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Application Information We anticipate the application window for this opening will reputed company on: 05/31/2026. reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job