**Fully Remote - Candidate must reside in one of the following five States - NJ, NY, PA , CT or MD**
This job will have the following responsibilities:
Assesses patient's behavioral health clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay.
Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures provided
Coordinates and assists in implementation of plan for members.
Monitors and coordinates services rendered outside of the network, as well as outside the local area, and coordinates internally for negotiation of fees for such services as appropriate.
Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
Encourages member participation and compliance in the behavioral health case/disease management program efforts.
Documents accurately and comprehensively based on the standards of practice and current organization policies
Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.
Qualifications & Requirements:
Requires a masters in a behavioral health related field
Requires a minimum of two (2) years behavioral health clinical experience
The following active/unrestricted NJ licenses are acceptable - LCSW, LMFT, LPC
Computer literate - MS Office products (Word, Excel, PowerPoint)
Behavioral health experience, preferably in a managed care setting, strongly preferred.
Certification in Applied Behavioral Analysis preferred
All qualified and interested candidates, please send your most updated resumes to edemey@judge.com for immediate consideration!
Contact: edemey@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
