• Manage the Authorization process end to end, from initial notification, entry and submission of required information, follow up all the way to determination and discharge. • Maintain detailed documentation of the record in the EMR system, in the internal CorroHealth system and in the Health Payer portals. • Verify correct eligibility and benefits for patients. • Act as a liaison between the hospital staff and the Health Payer to facilitate information sharing and successful process completion within allocated timeframe. • Review timely filing guidelines regarding the utilization management process. • Track and follow up with payers on pending authorizations to ensure timely responses. • Contact payer to elicit further information regarding status, decisions and remove hurdles in the processing. • Identify and escalate issues that may result in delays or denials. • Manage assigned workload of accounts through timely follow up and accurate record keeping. • Maintain compliance with HIPAA and other healthcare regulations.

• Responsible for the evaluation, development, running, and monitoring of testing execution • Provide testing updates on project-driven enhancements, routine updates, and requests for change • Analyze features/components and identify enhancement opportunities

Role Description Affect is transforming behavioral health care by combining mobile technology with counseling and medical services, offering 100% virtual treatment. We break down barriers to care, making it more accessible and effective for our members. Our innovative approach integrates a smartphone app with a dedicated care team to deliver real-time, data-driven treatment for better outcomes and lower costs. As a PMHNP, you’ll play a key role in member care alongside a collaborative team of counselors, therapists, peer support specialists, and case managers. You’ll provide evidence-based treatment for individuals with substance use disorders and mental health disorders. Affect specializes in substance-specific care. We prescribe Suboxone for Opioid Use Disorder and do not prescribe other controlled substances. While we provide extensive training in our treatment approach, clinical decisions remain at the provider’s discretion in collaboration with the member. You must hold an active, unrestricted license in Illinois. We have a full-time and part-time opportunity in Illinois! Key Responsibilities - Conduct initial and follow up telehealth evaluations - Deliver care for both substance use and mental health conditions - Prescribe medications as appropriate and answer member questions - Complete documentation in our EHR (Healthie) - Collaborate with your care team and attend occasional scheduled team meetings Requirements - Active and verifiable PMHNP license (Medicaid enrollment is a plus) in the state(s) where you practice, as well as your state of residence if it is not Illinois - At least 2 years of experience, ideally in addiction or mental health treatment. We will consider relevant previous experience for those with less than 2 years experience as a PMHNP - Experience prescribing Suboxone and active DEA registration - Willingness to obtain multi-state licensure (cost covered by Affect) - Empathy for members facing behavioral health challenges - Comfort using technology, including EHRs and mobile apps Benefits - Competitive compensation - Remote flexibility - Professional growth - A strong, supportive culture Additional Information You’ll need a quiet, private office with a reliable internet connection for HIPAA-compliant telehealth visits. The role may include periodic meetings with internal teams; reasonable accommodations are available as needed. Why Join Affect? We are passionate about reimagining behavioral health treatment. Join a mission-driven team focused on meaningful work, helping us reshape the future of substance use disorder and mental health care!

• Leads the pre-certification section in daily activities and prioritization of assignments • Assists in adjusting daily assignments based on coverage needs of the team and unit • Answers the pre-certification phone lines; assists with billing inquiries, insurance questions, and missing order and pre-certification issues • Acts as liaison between department facilities and physician offices • Contacts appropriate insurance companies for benefit verification and pre-certification of procedures and testing • Supplies all documentation required during pre-certification process to insurance companies • Documents when pre-certification is received from insurance companies and maintains open communication with physicians and their assistants regarding concerns or when physician involvement is needed • Provides training and education to staff • Assists staff with complex cases avoiding denials and physician peer to pears • Reviews denials to see if there is a potential for re-consideration • Provides feedback to management regarding staffing concerns and process improvement