Licensed Behavioral Health Coordinator

A company is looking for a Care Management Coordinator Behavioral Health (UM) to evaluate members' behavioral health conditions and determine the medical necessity for services.

Key Responsibilities

Evaluate and determine medical necessity for services using advanced medical knowledge and established criteria

Communicate with providers regarding treatment plans and clarify medical needs for services

Ensure compliance with regulations and maintain accurate documentation of key functions

Qualifications

LCSW, LSW, LMFT, LPC, or active PA Licensed RN; BSN preferred

Minimum of three years of behavioral health clinical experience in a healthcare setting

Prior behavioral health utilization management experience is desirable

Medical management / precertification experience preferred

Proficiency in Microsoft Office applications and ability to learn new systems