Work Location: This is remote, in Texas. Manager prefers candidates near Austin or San Antonio , but open to Dallas/Fort Worth area. The manager is also open to candidates in NM if necessary
Contract: 2025-05-19 to 2025-12-31
Description:
The position is 100% on a clinical queue. It is staffed only with behavioral health clinicians because they are making clinical decisions to approve treatment requests or send for peer review doc to doc review. The clinicians take incoming calls from providers asking for authorization. There are times a member in crisis is routed to the queue and the clinician will assist the member through their crisis at that time.
JOB SUMMARY:
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits.
JOB REQUIREMENTS:
PREFERRED JOB REQUIREMENTS:
...and teammates. Job Summary The Licensed Practical Nurse (LPN) Medical/Surgical Provides direct and indirect patient care... ...optimal outcomes in accordance with established nursing standards and hospital policies Essential Functions Provides direct patient care,...
Isler Group, LLC has an excellent opportunity for the right CPA! Our Firm is growing and we're looking for team members interested in an opportunity for growth.The Tax Manager will be responsible for managing client engagements and supervising team members. Clients will...
...Pink Power Cleaning is seeking a full-time professional Home Cleaner to join our team. We... ...exceptional cleaning services to homes and offices, making a positive impact on our clients... ...50; Benefits #128150; No nights or weekends Weekly pay and tips Health...
***This is NOT a job at ForceBrands*****Must have 10 YOE in NPD** Key Responsibilities : Lead the formulation, renovation, and commercialization of new products Oversee R&D project lifecycle: from ingredient sourcing, costing, and labeling to post-launch monitoring...
IT Desktop Support Analyst needs 3 years' IT Desktop support experience IT Desktop Support Analyst requires: OnSite 5 days a week. 3 years' work experience as an IT or Desktop Support Technician. Familiarity with networking systems and protocols. Knowledge...