Responsible for handling inbound calls, from providers and members in a call center / cue based environment. Conduct initial clinical assessments and determine appropriate levels of care, based on medical necessity. Explain and administer benefits according to plan descriptions for all levels of care (OP, IOP, PHP, RTC, IP)Ability to quickly assess and meet time sensitive deadlines within the Utilization management setting. Ability to manage and resolve complex or escalated callers / issues in fast paced environment. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications : Master's degree in psychology, Social Work or Marriage and Family Therapy, LPCC, or PhD / Psy. D - Clinical license in LCSW, LMFT, LPCC that is active and unrestricted in the state of California 2 years of experience...Behavioral Health, Health, Behavioral, Advocate, Remote, Healthcare, Behavior
Behavioral Health Advocate • Fresno, CA, US