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Episodic Care Manager – Behavioral Health, Autism Services

ManagerManagerOtherRemoteSeniorTeam 501-1,000Since 1997H1B No SponsorCompany SiteLinkedIn

Location

North Carolina

Posted

107 days ago

Salary

$73.7K - $117.9K / year

Seniority

Senior

Professional Certificate3 yrs expEnglish

Job Description

Episodic Care Manager – Behavioral Health, Autism Services

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• Perform clinical reviews to assess, facilitate, and coordinate the delivery of health care services • Effectively coordinate with providers, members, and internal staff • Review and evaluate cases for medical necessity against medical policy, benefits and/or care guidelines and regulations • Provide notifications to member and/or provider, according to regulatory requirements • Assess appropriateness for secondary case review by the Medical Director (MD) for denials

Job Requirements

  • BCBA licensure with a minimum of 3 years of clinical experience
  • Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties
  • Previous experience with utilization management in Behavioral Health strongly preferred

Benefits

  • Medical, dental, and vision coverage along with numerous health and wellness programs
  • Parental leave and support plus adoption and surrogacy assistance
  • Career development programs and tuition reimbursement for continued education
  • 401k match including an annual company contribution
  • Work-life balance, flexibility, and the autonomy to do great work

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