This role involves conducting telephonic assessments to ensure that healthcare services, particularly in behavioral health, are both clinically appropriate and cost-effective. As a key decision-maker in care coordination, you will review patient cases, evaluate treatment plans, and support optimal resource utilization.
Key Responsibilities
- Review clinical documentation to determine the appropriateness of care levels and services
- Ensure compliance with established medical necessity guidelines
- Communicate with providers and care teams to gather clinical information
- Document evaluations accurately and efficiently in the case management system
Required Qualifications
- Hold an active LCSW, LPC, LMFT, Ph.D., or Psy.D. license
- Proven experience in utilization management or clinical chart review
- Strong typing speed and accuracy for timely documentation
Preferred Qualifications
- Prior work in behavioral health settings
Work Environment
This is a fully remote position with no required office presence. The schedule is structured to support consistent case review and collaboration with clinical teams.
Compensation
Hourly rate ranges from $32.00 to $38.00, based on experience and qualifications.
