• Provide individual, family, and group therapy to children with severe emotional disturbance and their families. • Complete clinical assessments, develop diagnoses, and create person/family-centered treatment plans. • Maintain a minimum of 6 service hours per family per month (at least 4 must be face-to-face). • Ensure timely completion and updating of CAFAS/PECFAS and MichiCANS assessments. • Keep accurate documentation in both electronic and paper charts, including progress notes and treatment plans. • Participate in supervision and team meetings to review client progress and strategize support. • Provide 24/7 crisis intervention support on a rotating basis. • Ensure compliance with funder and agency documentation standards. • Approve and deliver only medically necessary and approved therapeutic services. • Apply trauma-informed and co-occurring disorder care practices. • Must be willing to assist individuals with trauma-related issues. • Travel throughout the designated area using a personal or agency vehicle to deliver community-based services.

• Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and NCQA standards • Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal • Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards • Communicates with members, providers, facilities, and other departments regarding appeals requests • Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards • Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests • Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices • Performs other duties as assigned • Complies with all policies and standards

• Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards • Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal • Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards • Communicates with members, providers, facilities, and other departments regarding appeals requests • Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards • Works with leadership to increase consistency, efficiency, and appropriateness of responses of all appeals requests • Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices • Performs other duties as assigned • Complies with all policies and standards

• Conduct online “Video Visits” with health plan members • Provide 40 hours of availability weekly, consistently providing 320+ capacity units per month • Execute a strong visit completion rate, consistently pacing 220+ completed visits per month • Maintain training, affiliation, and compliance with Video Visit requirements (regular training required)