Behavioral Health Care Planner

Job Summary

Working remotely full-time, the Behavioral Health Care Planner will support clinical teams in enhancing member care quality, prepare medical necessity determination letters, and ensure compliance with state regulations while collaborating with medical directors and clinicians.

Key responsibilities

• Support clinical teams to enhance the quality and coordination of member care
• Prepare administrative and medical necessity determination letters with accuracy and clarity
• Communicate results of medical reviews to providers and utilization teams, including next steps

Required qualifications

• 2+ years of experience in health insurance, administrative work, or customer service within a healthcare or mental health environment
• Ability to type 60-70 words per minute
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel)
• Associate degree or equivalent experience in the healthcare industry