Behavioral Health Whole Person Care Hybrid- Tidewater

Job description

City/State Virginia Beach, VA Work Shift: First (Days) Overview: Overview Behavioral Health Utilization Management Care Coordinator is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, BH and ARTS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers. Ensures appropriate and accurate information is entered into the claims system for processing of payment. Education: Master’s degree in Counseling , Social Work, or Marriage and Family Therapy required . For Registered Nurses, a Bachelor of Science in nursing is required . Certification/Licensure: Required license must be valid in state of practice. One of the following qualifies: Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social...