Job Description

Job Description

Behavioral Health Care Coordinator

Join Our Team as a Remote Behavioral Health Care Coordinator

We are seeking a highly skilled and experienced Behavioral Health Care Coordinator to join our team. As a Behavioral Health Care Coordinator, you will play a critical role in ensuring accurate and timely clinical review of behavioral health cases for medical necessity, working closely with members, reviewing medical records, and utilizing knowledge of medical necessity criteria for various levels of behavioral health care.

About the Role:

As a Behavioral Health Care Coordinator, you will be responsible for:

• Reviewing clinical cases for medical necessity
• Assisting members over the phone
• Reviewing medical records
• Interpreting behavioral health diagnoses
• Applying medical necessity criteria for outpatient office visits and acute inpatient care

Required Skills:

• Master's-level Behavioral Health Professional with an active, current license to practice at the independent practice level
• Current clinical license to practice in the state of operations and in good standing
• 3 years of clinical experience in a psychiatric setting or own behavioral health practice
• Excellent verbal and written communication skills
• Strong analytical and decision-making skills
• Proficiency in PC and database experience

Preferred Skills:

• Utilization review experience
• Knowledge of medical necessity criteria for various levels of behavioral health care

Other Requirements:

• Ability to work independently as a remote worker
• Strong organizational and time management skills
• Ability to maintain confidentiality and handle sensitive information

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