This is a fully remote position, open to applicants in Alabama, +42 more states.

📋 Description

• Evaluate preauthorization requests for behavioral health services utilizing evidence-based protocols and clinical expertise.

• Coordinate, document, and relay utilization management decisions to providers and stakeholders.

• Handle crisis calls, assess risk levels, identify support requirements, and facilitate suitable interventions, including escalation for suicide risk, self-harm issues, and welfare checks as needed.

• Leverage clinical knowledge to promote quality, cost-effective care and favorable member outcomes.

• Operate in a dynamic, queue-driven environment while juggling multiple priorities.

• Collaborate with providers and care teams to ensure appropriate levels of care are provided.

• Adhere to the designated night-shift schedule: Saturday and Sunday 12pm–10pm MT; Thursday and Friday 3pm–1am MT.

⛳️ Requirements

• An active, unrestricted independent behavioral health clinical license in the state of residence: LCSW, LICSW, LISW, LMSW, LPC, LMHC, LCMHC, LMFT, Clinical Psychologist, or RN.

• A minimum of 3 years of post-licensure experience in behavioral health.

• At least 3 years of experience addressing mental health and substance use disorders.

• Capability to effectively manage telephonic and computer-based tasks concurrently.

• High-speed residential internet service with a minimum download speed of 25 Mbps and upload speed of 3 Mbps.

• Willingness to work during holidays.

• For Behavioral Health Clinicians: A Master's degree in Social Work, Counseling, or Psychology.

• For Registered Nurses: A Bachelor's degree in Nursing with a focus on Behavioral Health or Psychology.

• Experience in a hospital-based behavioral health setting is preferred.

• Prior experience in Utilization Management or Prior Authorization is preferred.

• Managed Care experience is preferred.