Description
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is responsible for supervising staff involved in Behavioral Health Care Utilization Management (UM) including preauthorization, prospective. Concurrent, and retrospective review. This position is responsible for assisting in developing and implementing behavioral health care policies, procedures and initiatives related to Utilization Management and UM services and monitoring and assisting department in achieving goals.JOB REQUIREMENTS:
*Registered Nurse or Masters-level Behavioral Health Professional (LPC, LCPC, LMFT, LCSW, RPsy) with current, valid license in good standing (independent practice license, if a BH Professional) in the State of TX.
*3 years clinical experience (post licensure at the independent practice level) in psychiatric setting or own behavioral health practice.
* 3 years behavioral health utilization review or Behavioral Health Utilization Management experience (post licensure at the independent practice level).
* Knowledge of medical terminology.
* Knowledge of accrediting agency standards and regulations.
*Knowledge of behavioral health products, processes, community services and trends.
* Leadership/Management experience.
* Project management skills.
* Verbal and written communication skills.
* Analytical and decision-making skills.
* PC and database experience.
PREFERRED JOB REQUIREMENTS:
*Although posted as “Utilization Management”, this Position will also support Case Management and OP Utilization Management.
*Exposure to Managed Care – Utilization Management, Utilization Review, Case Management.
**Preferred Skills needed: Report Creation experience; Client Interfacing; Knowledge of NCQA, URAC, TDI Standards**
** Masters-level Behavioral Health Professionals: Please note that you MUST be licensed to practice at the independent level for this role. The # of years of clinical experience required for this role is post licensure (# of years) at the independent level**
#LI-FW1
#LI-Remote
This is a Telecommute (Remote) role for Richardson, Texas.
**You must live in, or near, Richardson, TX . **
Sponsorship is not available
Compensation: $69,200.00 - $146,700.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards
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