Job Summary
A company is looking for a Behavioral Health Utilization Management Care Coordinator (LCSW/LPC/LMFT/RN) to work remotely in Virginia and North Carolina.
Key Responsibilities
- Review clinical information to ensure it meets Medical Necessity Criteria for service authorization
- Maintain knowledge of medical necessity criteria, DMAS protocols, and compliance requirements
- Enter accurate information into the claims system for payment processing
Required Qualifications, Training, and Education
- Master's Degree in Social Work or Counseling or Bachelor's Degree in Nursing is required
- Current license as LCSW, LPC, LMFT, or RN in Virginia is required
- Two years of clinical experience is required
- Two years of experience in behavioral health and one year in care coordination is required
- One year of case management experience is preferred
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