Tennessee Licensed Behavioral Health Manager

Job Summary

To support the management of care decisions, the full-time Tennessee Licensed Behavioral Health Manager will work remotely, utilizing their expertise in behavioral health and withdrawal management to assist with clinical reviews and coordinate care effectively.

Key responsibilities

• Assist non-clinical staff in performance of administrative reviews and initiate referrals for care coordination
• Perform comprehensive provider and member appeals, denial interpretation, and retrospective claim reviews using clinical judgment
• Present cases during clinical rounds and navigate the continuum of care for behavioral health and withdrawal management

Required qualifications

• Current, active unrestricted Tennessee license in Nursing (RN) or a master's level behavioral health field (e.g., LCSW, LPC)
• 3 years of clinical behavioral health or substance use disorder experience
• 1 year of knowledge regarding community care resources and levels of behavioral health care
• Experience in psychiatric and/or substance use treatment settings
• Prior experience in Utilization Management or Managed Care