Work Location: This is remote, in Texas. Manager prefers candidates near Austin or San Antonio , but open to Dallas/Fort Worth area. The manager is also open to candidates in NM if necessary
Contract: 2025-05-19 to 2025-12-31
Description:
The position is 100% on a clinical queue. It is staffed only with behavioral health clinicians because they are making clinical decisions to approve treatment requests or send for peer review doc to doc review. The clinicians take incoming calls from providers asking for authorization. There are times a member in crisis is routed to the queue and the clinician will assist the member through their crisis at that time.
JOB SUMMARY:
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits.
JOB REQUIREMENTS:
PREFERRED JOB REQUIREMENTS:
...a demo at opengov.com Job Description: Administrative Business Partner to the Senior Executive Business Partner, Office of the CEO... ...take action to help us improve. If you have a great idea, we want to hear it. Excellent performance is recognized and rewarded,...
...a national non-profit dedicated to helping individuals with substance use and mental health disorders. Established in 1968, Gateway... ...00PM-12:00AM (40 hour work week) Residential Substance Abuse Counselors are responsible for: Preparing and facilitating group...
...Adecco is currently partnering with one of the premier distributors of oncology and specialty medications to fill a key onsite Pharmacy Technician Fulfillment role at their Irving, Texas facility. Apply today! Requirements : To be considered for this role you must have...
Dodd Creative Group is looking for an experienced and versatile Art Director to bring high-level visual execution and design excellence to our fast-paced studio. This role will focus on developing original logo designs, signage and wayfinding concepts, and environmental...
...Glassdoor's Best Places to Work 2023 , Forbes 50 Most Promising AI Companies , Wing Venture Capital's Enterprise Tech 30 , and Gartner's Magic Quadrant. We work in a highly collaborative environment, and strive to foster a positive, inclusive culture. Were backed by...