Behavioral UM Case Manager

Daily Responsibilities:

Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient and outpatient care settings

Goal is to determine whether or not the treatment is cost effective and necessary

The UM role would be a combo of field based work and working onsite

Territory will be in Tampa and surrounding Suburbs. * No state wide travel

Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality of care, collect and analyze utilization and cost of care data, assist with discharge planning, arrange transportation; provide member assistance and participate in special utilization projects.

Requirements:

Must be an LPC, LCSW, LMFT, or Psychologist

Minimum of 3 years’ experience in Behavioral Health

Minimum 2 years of UM experience (Concurrent Review/Prior Auth)

Interqual or Milliman preferred

Working knowledge of utilization review procedures, mental health and substance abuse

Familiarity with community resources and network providers

Concurrent Review - Chart Review/Discharge Planning

Prior Authorization - Managed Care Company – Giving approvals, Hospital Setting Requesting approval

Hours for this Position:

Monday – Friday, 8:00am – 5:00pm

Advantages of this Opportunity:

Competitive salary, negotiable based on relevant experience

Benefits offered, Medical, Dental, and Vision

Fun and positive work environment

Want More Information?

• If you are interested in applying to this position, please contact Ashley Greene @ 407-478-0332 ext 169 or email and click the Green "I’m Interested" Button to email your resume.