Job Overview
~~ Work schedule – Saturday and Sunday 8:30 am to 8:30 pm (12 hours per day = 24 hours) ~~
BASIC FUNCTION:
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:
- Registered Nurse (RN) with current license or Masters-level Behavioral Health Professional with current license to practice at the independent practice level. Current clinical license in state of operations and in good standings.
- 3 years clinical experience in psychiatric setting or own behavioral health practice.
- Verbal and written communication skills.
- Analytical and decision making skills.
- PC and database experience.
PREFERRED JOB REQUIREMENTS:
- Utilization review experience.
- Ability to work 24 hours every weekend from either 8:00 AM – 8:00 PM or 8:00 PM – 8:00 AM
This role will telecommute for applicants who live within a 100 mile radius of our Chicago, IL; Albuquerque, NM; Tulsa, OK; RIchardson, TX office
- CA
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HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.
Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC’s Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to “my account” and click on “View your job submissions”.