Telecommute Healthcare Benefits Determination Utilization Manager

Job ID: Available for Members

Location: Missouri

Compensation: To Be Discussed

Posted: Friday, February 16, 2018

Job Category: Healthcare, Insurance

Telecommute Level: 100% Telecommute

Travel Requirements: No Travel

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Manager

Job Summary

A behavioral health company needs applicants for an opening for a Telecommute Healthcare Benefits Determination Utilization Manager.

Individual must be able to fulfill the following responsibilities:

  • Provide oversight and/or assist with benefit determinations
  • Monitor IRO and physician advisor timeliness and provide reminder communication as needed
  • Coordinate with the appeals team on the retrospective review process

Required Skills:

  • Current, unrestricted license as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or as a Registered Nurse
  • Minimum of 3-5 years of experience in a facility-based outpatient psychiatric or chemical dependency treatment center
  • Strong clinical skills
  • Strong computer and keyboarding skills (Microsoft Outlook and Word)
  • Ability to comprehend medical policy and criteria to clearly articulate health information
  • Experience with UM processes in accordance to URAC and NCQA